Healthcare Provider Details

I. General information

NPI: 1851581813
Provider Name (Legal Business Name): MARIAN ELIZABRTH MILLER LMW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 MILLS AVE
GREENVILLE SC
29605-4015
US

IV. Provider business mailing address

393 UPPER GLADE CREEK RD
PISGAH FOREST NC
28768-9781
US

V. Phone/Fax

Practice location:
  • Phone: 864-233-5513
  • Fax: 864-233-5531
Mailing address:
  • Phone: 828-384-0306
  • Fax: 864-233-5531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLMW033
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: