Healthcare Provider Details

I. General information

NPI: 1841347721
Provider Name (Legal Business Name): MATTHEW SCOTT MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3803 BEDFORD AVE STE 202
NASHVILLE TN
37215-2531
US

IV. Provider business mailing address

3803 BEDFORD AVE STE 202
NASHVILLE TN
37215-2531
US

V. Phone/Fax

Practice location:
  • Phone: 615-808-0700
  • Fax: 615-808-0703
Mailing address:
  • Phone: 615-808-0700
  • Fax: 615-808-0703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD0000039662
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD0000039662
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: