MEDICARE: DR. MICHAEL JOHN 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	207RC0000X	Cardiovascular Disease Physician	32015	NC
2	207RI0011X	Interventional Cardiology Physician	32015	NC
3	207R00000X	Internal Medicine Physician	32015	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	60045022	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	59111	OTHER	NC	BCBS NC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194719559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JOHN MILLER MD

Provider Business Mailing Address
First Line	:	3637 CAPE CENTER DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4457
Country	:	US
Telephone Number	:	910-491-1760
Fax Number	:	910-491-1764

Provider Business Practice Location Address
First Line	:	3637 CAPE CENTER DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4457
Country	:	US
Telephone Number	:	910-491-1760
Fax Number	:	910-491-1764

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	09/01/2022

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Directions to “ DR. MICHAEL JOHN MILLER MD” Practice Location

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