MEDICARE: DR. BJORN P 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	207P00000X	Emergency Medicine Physician	054814	GA
2	207P00000X	Emergency Medicine Physician	27236	SC
3	207P00000X	Emergency Medicine Physician	MD428046	PA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295779098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BJORN P MILLER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 50520
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29485-0520
Country	:	US
Telephone Number	:	843-552-4240
Fax Number	:	843-552-4121

Provider Business Practice Location Address
First Line	:	1101 BOWMAN RD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-3213
Country	:	US
Telephone Number	:	843-552-4240
Fax Number	:	843-552-4121

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	03/14/2013

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