Healthcare Provider Details

I. General information

NPI: 1730122268
Provider Name (Legal Business Name): MICHAEL SETH MILLER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 SHORE DR STE 315
INDIANAPOLIS IN
46254-4693
US

IV. Provider business mailing address

3850 SHORE DR STE 315
INDIANAPOLIS IN
46254-4693
US

V. Phone/Fax

Practice location:
  • Phone: 317-429-0061
  • Fax: 317-222-1953
Mailing address:
  • Phone: 317-429-0061
  • Fax: 317-222-1953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086H0002X
TaxonomyHospice and Palliative Medicine (Surgery) Physician
License Number02001905A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number02001905A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number02001905A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: