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General NPI Number Information
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NPI Number | 1144481433
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Entity Type | Organization
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Legal Business Name | DR GLENN GALBRAITH MILLER, MEDICINE PC
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 700 FAYETTE ST
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-1707
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Country | US
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Telephone | 610-825-9665
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Fax |
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Provider Business Mailing Address
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Address Line | 700 FAYETTE ST
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-1707
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Country | US
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Telephone | 610-825-9665
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. GLENN GALBRAITH MILLER
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Credential | D.O.
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Telephone | 610-828-0358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | OS004427L
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License Number State | PA
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