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General NPI Number Information
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NPI Number | 1982901161
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Entity Type | Individual
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Provider Name | JONATHAN B MILLER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/23/2011
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 3237 CHESTNUT RIDGE RD
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City | GRANTSVILLE
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State | MD
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Zip | 21536-1370
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Country | US
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Telephone | 301-895-5315
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Fax | 301-895-4069
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Provider Business Mailing Address
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Address Line | 3237 CHESTNUT RIDGE RD PO BOX 86
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City | GRANTSVILLE
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State | MD
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Zip | 21536-1370
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Country | US
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Telephone | 301-895-5315
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Fax | 301-895-4069
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18127
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License Number State | MD
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