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General NPI Number Information
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NPI Number | 1750455218
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Entity Type | Individual
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Provider Name | LISA W MILLER MD
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Gender | Female
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 8 PIKES HL STE 2
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City | NORWAY
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State | ME
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Zip | 04268-5340
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Country | US
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Telephone | 207-743-9292
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Fax | 207-743-1578
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Provider Business Mailing Address
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Address Line | 301C US ROUTE 1
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City | SCARBOROUGH
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State | ME
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Zip | 04074-9701
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Country | US
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Telephone | 207-396-8600
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Fax | 207-396-8632
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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 | 017468
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | MD17468
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License Number State | ME
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