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General NPI Number Information
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NPI Number | 1831149723
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Entity Type | Organization
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Legal Business Name | MILLER FOOT & ANKLE HEALTHCARE, INC.
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 650 HENDERSON DRIVE, SUITE 505
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City | CARTERSVILLE
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State | GA
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Zip | 30120-3723
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Country | US
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Telephone | 770-386-1234
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Fax | 770-386-1250
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Provider Business Mailing Address
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Address Line | 3450 ACWORTH DUE WEST RD, SUITE 320
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City | KENNESAW
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State | GA
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Zip | 30144-1002
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Country | US
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Telephone | 770-386-1234
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Fax | 678-574-5549
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL S. MILLER
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Credential | DPM
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Telephone | 770-386-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD000776
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 000776
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | POD000776
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | POD000776
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License Number State | GA
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