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NPI Code Detail

MEDICARE: JERAD P MILLER MD

MEDICARE:   JERAD P 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
1208600000XSurgery Physician35083353OH
2208600000XSurgery Physician2008004273MO

General Provider Information

NPI Number : 1205878279
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERAD P MILLER MD
Provider Business Mailing Address
First Line : 70 JUNGERMANN CIR STE 405
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-1637
Country : US
Telephone Number : 636-916-7100
Fax Number : 636-916-7110
Provider Business Practice Location Address
First Line : 70 JUNGERMANN CIR STE 405
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-1637
Country : US
Telephone Number : 636-916-7100
Fax Number : 636-916-7110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 06/23/2026

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Directions to “ JERAD P MILLER MD” Practice Location

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