Healthcare Provider Details

I. General information

NPI: 1093835639
Provider Name (Legal Business Name): GEORGE ANDREW MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 09/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 15TH AVE E
SEATTLE WA
98112-5103
US

IV. Provider business mailing address

PO BOX 34584
SEATTLE WA
98124-1584
US

V. Phone/Fax

Practice location:
  • Phone: 206-326-3000
  • Fax:
Mailing address:
  • Phone: 509-241-7349
  • Fax: 509-241-7628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberMD00021552
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberMD00021552
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: