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General NPI Number Information
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NPI Number | 1548293335
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Entity Type | Organization
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Legal Business Name | MILLER BOSELLI INTERNAL MEDICINE
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 205 N BROAD STREET SUITE 100
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City | PHILADELPHIA
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State | PA
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Zip | 19107
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Country | US
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Telephone | 215-587-8008
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Fax | 215-587-6248
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Provider Business Mailing Address
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Address Line | 205 N BROAD STREET SUITE 100
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City | PHILADELPHIA
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State | PA
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Zip | 19107
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Country | US
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Telephone | 215-587-8008
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Fax | 215-587-6248
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Authorized Official
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Title or Position | PRESIDENT PHYSICIAN
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Name | HOWARD A MILLER
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Credential | MD
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Telephone | 215-587-8008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD030504E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD016828E
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License Number State | PA
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