MEDICARE: ZADOK MILLER

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	163W00000X	Registered Nurse	0001274278	VA
2	367500000X	Certified Registered Nurse Anesthetist	0024197715	VA

General Provider Information

NPI Number	:	1093672057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZADOK MILLER

Provider Business Mailing Address
First Line	:	11409 HALTONSHIRE WAY
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-4837
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11409 HALTONSHIRE WAY
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-4837
Country	:	US
Telephone Number	:	804-926-1611
Fax Number	:

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

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	06/10/2026

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Directions to “ ZADOK MILLER ” Practice Location

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