Healthcare Provider Details

I. General information

NPI: 1205907755
Provider Name (Legal Business Name): YEGANEH MILLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF NEVADA RENO STUDENT HEALTH CTR REDFIELD BLD MAILSTOP 196
RENO NV
89557-0001
US

IV. Provider business mailing address

UNIVERSITY OF NEVADA RENO STUDENT HEALTH CTR REDFIELD BLD MAILSTOP 196
RENO NV
89557-0001
US

V. Phone/Fax

Practice location:
  • Phone: 775-784-6598
  • Fax: 775-784-1298
Mailing address:
  • Phone: 775-784-6598
  • Fax: 775-784-1298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number9593
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: