Healthcare Provider Details

I. General information

NPI: 1134559594
Provider Name (Legal Business Name): ERIC MILLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2013
Last Update Date: 11/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7180 HIGHLAND DR
PITTSBURGH PA
15206-1206
US

IV. Provider business mailing address

349 OAKLAND AVE APT 1
PITTSBURGH PA
15213-6026
US

V. Phone/Fax

Practice location:
  • Phone: 412-365-4900
  • Fax:
Mailing address:
  • Phone: 814-289-6087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: