Healthcare Provider Details

I. General information

NPI: 1144752445
Provider Name (Legal Business Name): AMY ELIZABETH MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 N MAIN ST STE 332
ENGLEWOOD OH
45415-1185
US

IV. Provider business mailing address

PO BOX 933432
CLEVELAND OH
44193-0039
US

V. Phone/Fax

Practice location:
  • Phone: 937-832-7337
  • Fax: 937-832-4817
Mailing address:
  • Phone: 937-641-3555
  • Fax: 937-641-4528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2021013728
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2021013728
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number2021013728
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.155758
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: