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NPI Code Detail

MEDICARE: DR. STANLEY DAVID MILLER O.D., M.S., FAAO

MEDICARE:  DR. STANLEY DAVID MILLER  O.D., M.S., FAAO
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
1152W00000XOptometrist2263MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1757526OTHERTUFTS HEALTH PLAN ID
2W15986OTHERMABCBS OF MASS
30891138 OR B2119401OTHERMACIGNA HEALTH CARE
42569545OTHERUS HEALTH AETNA
5152625OTHERMAHARVARD PILGRIM HEALTH

General Provider Information

NPI Number : 1477616423
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STANLEY DAVID MILLER O.D., M.S., FAAO
Provider Business Mailing Address
First Line : 9 BEMIS ST
Second Line :
City : WESTON
State : MA
Zip : 02493-1701
Country : US
Telephone Number : 781-899-7751
Fax Number : --
Provider Business Practice Location Address
First Line : 56 COLPITTS RD
Second Line : EYE & OPTICAL
City : WESTON
State : MA
Zip : 02493-1568
Country : US
Telephone Number : 781-899-7751
Fax Number : --
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 07/08/2007

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Directions to “ DR. STANLEY DAVID MILLER O.D., M.S., FAAO” Practice Location

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