Healthcare Provider Details

I. General information

NPI: 1821259581
Provider Name (Legal Business Name): ASHLEY K. MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 E JEFFERSON ST
ROCKVILLE MD
20852-4908
US

IV. Provider business mailing address

2101 E JEFFERSON ST
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 800-777-7904
  • Fax:
Mailing address:
  • Phone: 800-777-7904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0073124
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD038864
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101245846
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: