Healthcare Provider Details

I. General information

NPI: 1134514201
Provider Name (Legal Business Name): ERIC S MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2015
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1099 HELMO AVE N STE 225
OAKDALE MN
55128-6001
US

IV. Provider business mailing address

1099 HELMO AVE N STE 225
OAKDALE MN
55128-6001
US

V. Phone/Fax

Practice location:
  • Phone: 651-217-3511
  • Fax: 651-899-0135
Mailing address:
  • Phone: 651-217-3511
  • Fax: 651-899-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number72681-20
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number66705
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: