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General NPI Number Information
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NPI Number | 1477559425
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Entity Type | Individual
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Provider Name | ROBERT BENJAMIN MILLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 4343 PAN AMERICAN FWY NE STE 236
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-6834
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Country | US
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Telephone | 505-563-2800
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Fax | 505-563-2821
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Provider Business Mailing Address
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Address Line | PO BOX 1560
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City | LAS CRUCES
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State | NM
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Zip | 88004-1560
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Country | US
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Telephone | 505-563-2800
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Fax | 505-563-2821
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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 | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 98-339
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | 98-339
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License Number State | NM
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