Healthcare Provider Details

I. General information

NPI: 1700893609
Provider Name (Legal Business Name): MICHELLE ANN MILLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

700 CHILDRENS DR PHYSICAL MEDICINE AND REHABILITATION
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-5051
  • Fax: 614-722-5058
Mailing address:
  • Phone: 614-722-5051
  • Fax: 614-722-5058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35074792
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number35074792
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: