Healthcare Provider Details

I. General information

NPI: 1912983115
Provider Name (Legal Business Name): ANNE J MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 HOSPITAL RD. U MASS HEALTH ALLIANCE LEOMINSTER CAMPUS
LEOMINSTER MA
01453
US

IV. Provider business mailing address

668 WASHINGTON ST
BRIGHTON MA
02135-1612
US

V. Phone/Fax

Practice location:
  • Phone: 978-466-2000
  • Fax: 978-466-2000
Mailing address:
  • Phone: 617-202-5054
  • Fax: 617-202-5054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number54834
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number54834
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number54834
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: