Healthcare Provider Details

I. General information

NPI: 1740257799
Provider Name (Legal Business Name): GREGORY A MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 11/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

989 RIBAUT RD, SUITE 210 BEAUFORT MEMORIAL OBSTETRIC'S & GYNECOLOGY SPECIALISTS
BEAUFORT SC
29902
US

IV. Provider business mailing address

989 RIBAUT RD, STE 210 BEAUFORT MEMORIAL OBSTETRIC'S & GYNECOLOGY SPECIALISTS
BEAUFORT SC
29902
US

V. Phone/Fax

Practice location:
  • Phone: 843-522-7820
  • Fax: 843-522-7821
Mailing address:
  • Phone: 843-522-7820
  • Fax: 843-522-7821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number18834
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: