Healthcare Provider Details

I. General information

NPI: 1427031095
Provider Name (Legal Business Name): ANNA MILLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 MCAULEY DR SUITE 6016
YPSILANTI MI
48197-1014
US

IV. Provider business mailing address

5333 MCAULEY DR SUITE 6016
YPSILANTI MI
48197-1014
US

V. Phone/Fax

Practice location:
  • Phone: 734-712-8350
  • Fax: 734-712-8351
Mailing address:
  • Phone: 734-712-8350
  • Fax: 734-712-8351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number33764
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number33764
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD210002997
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number309976-01
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301055346
License Number StateMI
# 6
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4301055346
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: