MEDICARE: DR. ASHLEY J MILLER D.O.

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	5101024248	MI
2	207Q00000X	Family Medicine Physician	H85838	MD
3	207Q00000X	Family Medicine Physician	295157	NY
4	207Q00000X	Family Medicine Physician	277254	MA
5	207Q00000X	Family Medicine Physician	R9398	TX
6	207Q00000X	Family Medicine Physician	OS015831	PA

General Provider Information

NPI Number	:	1336464049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY J MILLER D.O.

Provider Business Mailing Address
First Line	:	1 W ELM ST
Second Line	:	SUITE 100
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-4108
Country	:	US
Telephone Number	:	610-567-5265
Fax Number	:	610-567-6955

Provider Business Practice Location Address
First Line	:	500 W GERMANTOWN PIKE
Second Line	:	SUITE 1020
City	:	PLYMOUTH MEETING
State	:	PA
Zip	:	19462-1353
Country	:	US
Telephone Number	:	610-941-4208
Fax Number	:	610-941-4158

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

Provider Enumeration Date	:	04/06/2010
Last Update Date	:	08/16/2019

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