MEDICARE: WENDY LEIGH MILLER M.D.

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
1	207Q00000X	Family Medicine Physician	D0072229	MD
2	207Q00000X	Family Medicine Physician	25928	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083613004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY LEIGH MILLER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 900
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21158-0900
Country	:	US
Telephone Number	:	410-871-6502
Fax Number	:

Provider Business Practice Location Address
First Line	:	605 W MAIN ST
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29072-2503
Country	:	US
Telephone Number	:	803-358-6100
Fax Number	:	803-358-6105

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	11/09/2020

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