MEDICARE: DR. TIMOTHY CHRISTOPHER MILLER OD

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	152W00000X	Optometrist	1585	NC

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	:	1336107754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY CHRISTOPHER MILLER OD

Provider Business Mailing Address
First Line	:	3720 SPARROW POND LN
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27606-8499
Country	:	US
Telephone Number	:	919-782-9091
Fax Number	:

Provider Business Practice Location Address
First Line	:	4151 MAIN AT NORTH HILLS ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-5784
Country	:	US
Telephone Number	:	919-782-9091
Fax Number	:

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	03/07/2008

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