Healthcare Provider Details

I. General information

NPI: 1457770950
Provider Name (Legal Business Name): MILLER ANESTHESIA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2014
Last Update Date: 04/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 SE 8TH AVE
HILLSBORO OR
97123-4246
US

IV. Provider business mailing address

335 SE 8TH AVE
HILLSBORO OR
97123-4246
US

V. Phone/Fax

Practice location:
  • Phone: 503-681-1892
  • Fax:
Mailing address:
  • Phone: 503-681-1892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAVI CHIKKALINGAIAH
Title or Position: PRESIDENT
Credential: MD
Phone: 541-740-3194