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NPI Code Detail

MEDICARE: MR. JOHN CARLE MILLER PA-C

MEDICARE: MR. JOHN CARLE MILLER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA1369SC

General Provider Information

NPI Number : 1053377283
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN CARLE MILLER PA-C
Provider Business Mailing Address
First Line : 2347 HWY 17 BUSINESS SOUTH
Second Line :
City : GARDEN CITY
State : SC
Zip : 29576-7611
Country : US
Telephone Number : 843-357-2443
Fax Number : 843-357-2132
Provider Business Practice Location Address
First Line : 2347 HWY 17 BUSINESS SOUTH
Second Line :
City : GARDEN CITY
State : SC
Zip : 29576-7611
Country : US
Telephone Number : 843-357-2443
Fax Number : 843-357-2132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 04/12/2012

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Directions to “ MR. JOHN CARLE MILLER PA-C” Practice Location

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