MEDICARE: DR. STUART H. MILLER MD

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	2085R0202X	Diagnostic Radiology Physician	25MA05577000	NJ
2	2085R0204X	Vascular & Interventional Radiology Physician	25MA05577000	NJ

General Provider Information

NPI Number	:	1134170293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STUART H. MILLER MD

Provider Business Mailing Address
First Line	:	390 ROUTE 10 W STE 102
Second Line	:
City	:	RANDOLPH
State	:	NJ
Zip	:	07869-2141
Country	:	US
Telephone Number	:	862-251-7111
Fax Number	:	862-251-4305

Provider Business Practice Location Address
First Line	:	390 ROUTE 10 W STE 102
Second Line	:
City	:	RANDOLPH
State	:	NJ
Zip	:	07869-2141
Country	:	US
Telephone Number	:	862-251-7111
Fax Number	:	862-251-4305

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

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	07/28/2021

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