Healthcare Provider Details

I. General information

NPI: 1265438543
Provider Name (Legal Business Name): FRANK PIERSOLL MILLER III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 S MAIN ST STE 304
OBERLIN OH
44074-1600
US

IV. Provider business mailing address

5 S MAIN ST STE 304
OBERLIN OH
44074-1600
US

V. Phone/Fax

Practice location:
  • Phone: 440-774-7300
  • Fax: 440-774-7002
Mailing address:
  • Phone: 440-774-7300
  • Fax: 440-774-7002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number35.067601
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: