Healthcare Provider Details

I. General information

NPI: 1265744593
Provider Name (Legal Business Name): MEREDITH WETHERBEE MILLER M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 VFW PKWY
WEST ROXBURY MA
02132-4927
US

IV. Provider business mailing address

1400 VFW PKWY
WEST ROXBURY MA
02132-4927
US

V. Phone/Fax

Practice location:
  • Phone: 857-203-6070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number258529
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: