Physician Compare National (NPI:1811930373)

HEALTHCARE PROVIDER: FRED MILLER III M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1811930373
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1951594589
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101015000068
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MILLER
	Individual professional last name
Provider First Name	FRED
	Individual professional first name
Provider Middle Name	WILLIAM
	Individual professional middle name
Provider Name Suffix Text	III
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	RUTGERS NEW JERSEY MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	1979
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	363 PARK ST
	Group Practice or individual's line 1 address
City	UPPER MONTCLAIR
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	070432237
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9737831550
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310054
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HACKENSACKUMC MOUNTAINSIDE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y