MEDICARE: PAUL M MILLER DO

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	208M00000X	Hospitalist Physician	OS004829L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00055488	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0054269000	OTHER	PA	INDEPENDENCE BLUE CROSS
3	1509	OTHER	PA	BRAVO HEALTH
4	30008822	OTHER	PA	KEYSTONE MERCY HEALTH
5	544679	OTHER	PA	COVENTRY HEALTH AMERICA
6	4576798	OTHER	PA	AETNA PPO
7	0002524501	OTHER	PA	AMERICHOICE
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	114738	OTHER	PA	HIGHMARK BLUE SHIELD
10	3466018	OTHER	PA	AETNA HMO

General Provider Information

NPI Number	:	1265416846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL M MILLER DO

Provider Business Mailing Address
First Line	:	PO BOX 820933
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19182-0933
Country	:	US
Telephone Number	:	215-728-2000
Fax Number	:	215-214-4119

Provider Business Practice Location Address
First Line	:	7600 CENTRAL AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2442
Country	:	US
Telephone Number	:	215-728-2000
Fax Number	:	215-214-4119

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

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	09/30/2013

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Directions to “ PAUL M MILLER DO” Practice Location

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