Healthcare Provider Details

I. General information

NPI: 1164537833
Provider Name (Legal Business Name): DAVID M MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MEDICAL PKWY
CARSON CITY NV
89703-4625
US

IV. Provider business mailing address

PO BOX 3299
CARSON CITY NV
89702-3299
US

V. Phone/Fax

Practice location:
  • Phone: 775-445-8795
  • Fax: 775-445-5175
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number15503
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: