Healthcare Provider Details

I. General information

NPI: 1881823821
Provider Name (Legal Business Name): PETER E MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2009
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7605 FOREST AVE STE 308
RICHMOND VA
23229-4939
US

IV. Provider business mailing address

7605 FOREST AVE STE 308
RICHMOND VA
23229-4939
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-7077
  • Fax:
Mailing address:
  • Phone: 804-288-7077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number240934
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number0101260090
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: