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General NPI Number Information
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NPI Number | 1750962411
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Entity Type | Individual
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Provider Name | NICHOLAS JON MILLER MD
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Gender | Male
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Dates
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Enumeration Date | 04/15/2021
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Last Update Date | 07/13/2025
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Provider Practice Location Address
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Address Line | 1105 SIXTH ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-2386
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Country | US
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Telephone | 989-859-2387
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Fax |
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Provider Business Mailing Address
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Address Line | 3208 N WALDO RD
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City | MIDLAND
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State | MI
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Zip | 48642-9733
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Country | US
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Telephone | 989-859-2387
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4301513894
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License Number State | MI
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