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General NPI Number Information
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NPI Number | 1366670168
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Entity Type | Individual
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Provider Name | STACY MILLER M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 2230 W BROAD ST STE 103
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City | RICHMOND
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State | VA
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Zip | 23220-2002
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Country | US
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Telephone | 804-325-8801
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 639970
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City | CINCINNATI
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State | OH
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Zip | 45263-9970
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101252232
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License Number State | VA
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