MEDICARE: KEVIN D 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
1	207L00000X	Anesthesiology Physician	25MA09842300	NJ

General Provider Information

NPI Number	:	1386904969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN D MILLER MD

Provider Business Mailing Address
First Line	:	193 W SYLVANIA AVE
Second Line	:
City	:	NEPTUNE CITY
State	:	NJ
Zip	:	07753-6239
Country	:	US
Telephone Number	:	732-897-0200
Fax Number	:	732-897-0263

Provider Business Practice Location Address
First Line	:	1945 STATE ROUTE 33
Second Line	:
City	:	NEPTUNE CITY
State	:	NJ
Zip	:	07753-4859
Country	:	US
Telephone Number	:	732-897-0200
Fax Number	:

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

Provider Enumeration Date	:	05/17/2012
Last Update Date	:	02/22/2017

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Directions to “ KEVIN D MILLER MD” Practice Location

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