Healthcare Provider Details

I. General information

NPI: 1942384995
Provider Name (Legal Business Name): STEPHEN B. MILLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 05/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5187 US ROUTE 60 E SUITE # 9
HUNTINGTON WV
25705-2076
US

IV. Provider business mailing address

5187 US ROUTE 60 E SUITE # 9
HUNTINGTON WV
25705-2076
US

V. Phone/Fax

Practice location:
  • Phone: 304-399-2222
  • Fax: 304-399-2223
Mailing address:
  • Phone: 304-399-2222
  • Fax: 304-399-2223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN B MILLER
Title or Position: OWNER
Credential: M.D.
Phone: 304-399-2222