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General NPI Number Information
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NPI Number | 1154324648
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Entity Type | Individual
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Provider Name | MARILYN DIANE MILLER M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 295 STONER AVE STE 205
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City | WESTMINSTER
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State | MD
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Zip | 21157-5637
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Country | US
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Telephone | 410-876-3380
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Fax | 410-876-5195
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Provider Business Mailing Address
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Address Line | 295 STONER AVE STE 205
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City | WESTMINSTER
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State | MD
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Zip | 21157-5637
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Country | US
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Telephone | 410-876-3380
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Fax | 410-876-5195
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | D18404
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | D0018404
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License Number State | MD
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