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General NPI Number Information
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NPI Number | 1013873637
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Entity Type | Organization
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Legal Business Name | MILLER DIVERSIFIED HEALTH PARTNERSHIPS LLC
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 7203 SARAH ST APT 1
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City | MAPLEWOOD
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State | MO
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Zip | 63143-2418
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Country | US
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Telephone | 314-669-1445
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 MARSHALL AVE PO BOX 434091
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City | MAPLEWOOD
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State | MO
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Zip | 63143-3100
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Country | US
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Telephone | 314-669-1445
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. BERNARD VICTOR MILLER III
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Credential | MD
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Telephone | 314-629-9023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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