Healthcare Provider Details

I. General information

NPI: 1447216403
Provider Name (Legal Business Name): MARVIN E MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE CHILDRENS PLAZA
DAYTON OH
45404
US

IV. Provider business mailing address

1 CHILDRENS PLZ
DAYTON OH
45404-1815
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3800
  • Fax: 937-641-5325
Mailing address:
  • Phone: 937-641-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number35-064454
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35064454
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: