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General NPI Number Information
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NPI Number | 1770656332
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Entity Type | Individual
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Provider Name | DAVID C MILLER MD
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Gender | Male
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 3738 LANDMARK DR STE A
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City | LAFAYETTE
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State | IN
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Zip | 47905
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Country | US
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Telephone | 765-807-2780
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Fax | 765-807-2781
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Provider Business Mailing Address
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Address Line | 8805 N MERIDIAN ST STE 100
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-2643
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Country | US
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Telephone | 317-706-7246
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Fax | 317-818-0929
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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 | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 01035762
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 01035762A
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License Number State | IN
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