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General NPI Number Information
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NPI Number | 1114233012
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Entity Type | Organization
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Legal Business Name | KENNETH MILLER MD LLC
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 2500 W ROGERS AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-4131
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Country | US
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Telephone | 443-240-1682
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Fax | 855-588-5951
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Provider Business Mailing Address
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Address Line | 2500 W ROGERS AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-4131
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Country | US
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Telephone | 443-240-1682
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Fax | 855-588-5951
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Authorized Official
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Title or Position | CREDENTIALING/CODING MANAGER
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Name | MRS. TARA L LALLIER
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Credential | CHONC
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Telephone | 321-362-5128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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