Healthcare Provider Details

I. General information

NPI: 1023067733
Provider Name (Legal Business Name): JAMES RICHARD MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 FIRST COLONIAL RD STE 300
VIRGINIA BEACH VA
23454-2409
US

IV. Provider business mailing address

1101 FIRST COLONIAL RD STE 300
VIRGINIA BEACH VA
23454-2409
US

V. Phone/Fax

Practice location:
  • Phone: 757-395-1760
  • Fax: 757-756-5148
Mailing address:
  • Phone: 757-395-1760
  • Fax: 757-756-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0101053971
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101053971
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: