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General NPI Number Information
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NPI Number | 1790899060
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Entity Type | Individual
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Provider Name | ELIZABETH A. MILLER DO
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Gender | Female
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 08/16/2019
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Provider Practice Location Address
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Address Line | 1156 HIGH ST
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City | SANTA CRUZ
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State | CA
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Zip | 95064-1099
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Country | US
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Telephone | 831-459-1740
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Fax | 831-459-1740
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Provider Business Mailing Address
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Address Line | 3725 MANORBROOK RD
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City | RALEIGH
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State | NC
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Zip | 27607-6009
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Country | US
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Telephone | 919-617-8521
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 2007-01057
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License Number State | NC
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