Healthcare Provider Details

I. General information

NPI: 1720405202
Provider Name (Legal Business Name): EMILY RATH MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 S FLOYD ST SUITE 412
LOUISVILLE KY
40202-3818
US

IV. Provider business mailing address

3333 BURNET AVE ML 7009
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-8828
  • Fax:
Mailing address:
  • Phone: 513-636-4830
  • Fax: 513-636-7868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number50140
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number50140
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35.139553
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: