MEDICARE: DR. JOANNE M 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	207P00000X	Emergency Medicine Physician	30804	IA

General Provider Information

NPI Number	:	1093777518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOANNE M MILLER M.D.

Provider Business Mailing Address
First Line	:	1935 E 47TH PL
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52807-1268
Country	:	US
Telephone Number	:	563-349-7829
Fax Number	:

Provider Business Practice Location Address
First Line	:	1351 W CENTRAL PARK AVE STE 1225
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52804-1889
Country	:	US
Telephone Number	:	563-421-1585
Fax Number	:	563-421-1595

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

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	08/02/2021

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