Healthcare Provider Details

I. General information

NPI: 1356307490
Provider Name (Legal Business Name): MICHAEL M MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 06/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 E WEISGARBER RD STE A
KNOXVILLE TN
37909-2648
US

IV. Provider business mailing address

7205 ROTHERWOOD DR
KNOXVILLE TN
37919-7415
US

V. Phone/Fax

Practice location:
  • Phone: 865-588-1833
  • Fax: 865-588-8057
Mailing address:
  • Phone: 865-588-8508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD0000010997
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberMD10997
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD10997
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: