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General NPI Number Information
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NPI Number | 1104890623
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Entity Type | Individual
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Provider Name | KAY T. MILLER M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 10/02/2009
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Provider Practice Location Address
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Address Line | 6770 DIXIE HWY SUITE #106
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City | CLARKSTON
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State | MI
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Zip | 48346-2087
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Country | US
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Telephone | 248-625-0300
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Fax | 248-625-0363
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Provider Business Mailing Address
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Address Line | 2234 COLONIAL BLVD MANAGED CARE DEPT
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 4301058072
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License Number State | MI
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