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General NPI Number Information
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NPI Number | 1740668631
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Entity Type | Individual
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Provider Name | JUSTIN MICHAEL MILLER DO
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Gender | Male
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 120 PINE ST
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City | TAMAQUA
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State | PA
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Zip | 18252-1409
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Country | US
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Telephone | 570-645-1835
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Fax | 570-645-1471
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Provider Business Mailing Address
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Address Line | 801 OSTRUM ST
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City | BETHLEHEM
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State | PA
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Zip | 18015-1000
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Country | US
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Telephone | 570-645-1835
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Fax | 570-645-1471
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | OS022375
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License Number State | PA
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