Healthcare Provider Details

I. General information

NPI: 1205905999
Provider Name (Legal Business Name): EDWARD V MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 CONCORD ST
FRAMINGHAM MA
01702-8305
US

IV. Provider business mailing address

20 CUTTING CROSS WAY
WAYLAND MA
01778-3844
US

V. Phone/Fax

Practice location:
  • Phone: 508-879-3204
  • Fax:
Mailing address:
  • Phone: 508-358-9964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number39412
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: