MEDICARE: DR. SUSAN G 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	208000000X	Pediatrics Physician	202372	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225024714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN G MILLER MD

Provider Business Mailing Address
First Line	:	500 HELENDALE RD
Second Line	:	SUITE LLE-10
City	:	ROCHESTER
State	:	NY
Zip	:	14609-3109
Country	:	US
Telephone Number	:	585-473-7028
Fax Number	:	585-473-0051

Provider Business Practice Location Address
First Line	:	500 HELENDALE RD
Second Line	:	SUITE 200
City	:	ROCHESTER
State	:	NY
Zip	:	14609-3173
Country	:	US
Telephone Number	:	585-473-7028
Fax Number	:	585-473-0051

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	03/11/2020

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