MEDICARE: DR. MATTHEW W. MILLER M.D.

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	207Q00000X	Family Medicine Physician	78450	OH

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	:	1225032964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW W. MILLER M.D.

Provider Business Mailing Address
First Line	:	140 FOX RD
Second Line	:	SUITE 201
City	:	VAN WERT
State	:	OH
Zip	:	45891-2475
Country	:	US
Telephone Number	:	419-232-2077
Fax Number	:	419-232-4498

Provider Business Practice Location Address
First Line	:	140 FOX RD
Second Line	:	SUITE 202
City	:	VAN WERT
State	:	OH
Zip	:	45891-2475
Country	:	US
Telephone Number	:	419-238-6735
Fax Number	:	419-232-5271

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	11/27/2023

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