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NPI Code Detail

MEDICARE: DR. KYLE MILLER MD

MEDICARE: DR. KYLE MILLER MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician29465WV

General Provider Information

NPI Number : 1386148013
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KYLE MILLER MD
Provider Business Mailing Address
First Line : 65 PROFESSIONAL PL STE 102103
Second Line :
City : BRIDGEPORT
State : WV
Zip : 26330-0258
Country : US
Telephone Number : 304-848-5770
Fax Number : 304-848-0890
Provider Business Practice Location Address
First Line : 65 PROFESSIONAL PL STE 102103
Second Line :
City : BRIDGEPORT
State : WV
Zip : 26330-0258
Country : US
Telephone Number : 304-848-5770
Fax Number : 304-848-0890
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2018
Last Update Date : 06/28/2021

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Directions to “ DR. KYLE MILLER MD” Practice Location

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