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General NPI Number Information
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NPI Number | 1821399239
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Entity Type | Individual
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Provider Name | TIMOTHY JUSTIN MILLER D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/16/2010
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 8926 WOODYARD RD STE 301
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City | CLINTON
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State | MD
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Zip | 20735-4220
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Country | US
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Telephone | 301-856-3670
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Fax | 301-868-0129
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Provider Business Mailing Address
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Address Line | 7801 OLD BRANCH AVE STE 300
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City | CLINTON
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State | MD
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Zip | 20735-1608
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Country | US
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Telephone | 301-856-6718
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Fax | 301-856-6599
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | H0081237
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 19096
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 15141C
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License Number State | WY
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0102202428
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License Number State | VA
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