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NPI 1093701476

NPI 1093701476 : ANDREW WADE MILLER D.P.M. : DOVER, OH

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General NPI Number Information
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    NPI Number           |    1093701476
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREW WADE MILLER D.P.M.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/21/2005
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    Last Update Date     |    05/12/2015
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Provider Practice Location Address
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    Address Line         |    515 UNION AVE SUITE 147
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    City                 |    DOVER
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    State                |    OH
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    Zip                  |    44622-3004
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    Country              |    US
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    Telephone            |    330-339-6233
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    Fax                  |    330-343-8460
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Provider Business Mailing Address
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    Address Line         |    515 UNION AVE SUITE 147
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    City                 |    DOVER
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    State                |    OH
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    Zip                  |    44622-3004
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    Country              |    US
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    Telephone            |    330-339-6233
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    Fax                  |    330-343-8460
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213ES0103X
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    Taxonomy Name        |    Foot & Ankle Surgery Podiatrist
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    License Number       |    3392
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    License Number State |    OH
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