Healthcare Provider Details

I. General information

NPI: 1922383082
Provider Name (Legal Business Name): STEVEN JOHN MILLER M.S.PHARM, D. PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 11/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 MARYLAND WAY C/O PHARMMD SUITE 200
BRENTWOOD TN
37027-5018
US

IV. Provider business mailing address

5200 MARYLAND WAY C/O PHARMMD SUITE 200
BRENTWOOD TN
37027-5018
US

V. Phone/Fax

Practice location:
  • Phone: 615-312-7043
  • Fax: 810-454-0437
Mailing address:
  • Phone: 615-312-7043
  • Fax: 810-454-0437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH015949
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP438147
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number14802
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number12233
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: