Healthcare Provider Details

I. General information

NPI: 1316380314
Provider Name (Legal Business Name): ANDREW JASON MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 01/31/2020
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1888 MARLTON PIKE E
CHERRY HILL NJ
08003-2178
US

IV. Provider business mailing address

1888 MARLTON PIKE E
CHERRY HILL NJ
08003-2178
US

V. Phone/Fax

Practice location:
  • Phone: 856-489-5634
  • Fax: 856-489-5631
Mailing address:
  • Phone: 856-489-3034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number63953
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD468156
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number25MA10617600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: