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NPI Code Detail

MEDICARE: DAVID D MILLER CRNA

MEDICARE:   DAVID D MILLER  CRNA
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
1174400000XSpecialist3390284406UT

General Provider Information

NPI Number : 1205838745
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID D MILLER CRNA
Provider Business Mailing Address
First Line : PO BOX 1512
Second Line :
City : LAYTON
State : UT
Zip : 84041-6512
Country : US
Telephone Number : 801-593-9223
Fax Number : 801-593-9626
Provider Business Practice Location Address
First Line : 3460 S 4155 W
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84120-2049
Country : US
Telephone Number : 801-964-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 02/15/2008

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Directions to “ DAVID D MILLER CRNA” Practice Location

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