MEDICARE: JEFFREY B 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	35-047519	OH
2	207RP1001X	Pulmonary Disease Physician	35-047519	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	341574729029	OTHER	OH	CARESOURCE
2	000000182183	OTHER	OH	UNISON HEALTH PLAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	341574729C	OTHER	OH	AULTCARE
5	000000134423	OTHER	OH	ANTHEM BC/BS
6	733558	OTHER	OH	BUCKEYE COMMUNITY HEALTH
7	Q015961D	OTHER	OH	THE HEALTH PLAN

General Provider Information

NPI Number	:	1083617724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY B MILLER M.D.

Provider Business Mailing Address
First Line	:	2600 TUSCARAWAS ST W
Second Line	:	STE 100
City	:	CANTON
State	:	OH
Zip	:	44708-4696
Country	:	US
Telephone Number	:	330-452-8844
Fax Number	:	330-452-7012

Provider Business Practice Location Address
First Line	:	2600 TUSCARAWAS ST W
Second Line	:	STE 100
City	:	CANTON
State	:	OH
Zip	:	44708-4696
Country	:	US
Telephone Number	:	330-452-8844
Fax Number	:	330-452-7012

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

Provider Enumeration Date	:	05/26/2005
Last Update Date	:	01/05/2011

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Directions to “ JEFFREY B MILLER M.D.” Practice Location

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