Healthcare Provider Details

I. General information

NPI: 1861574196
Provider Name (Legal Business Name): SCOT D MILLER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 05/28/2021
Certification Date: 05/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3975 EMBASSY PKWY
AKRON OH
44333-8320
US

IV. Provider business mailing address

3975 EMBASSY PKWY
AKRON OH
44333-8320
US

V. Phone/Fax

Practice location:
  • Phone: 330-668-4040
  • Fax: 330-668-4078
Mailing address:
  • Phone: 330-668-4040
  • Fax: 330-668-4078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number34003433
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number34.003433
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: