MEDICARE: DR. CELESTE 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	207Q00000X	Family Medicine Physician	164609	NC
2	207Q00000X	Family Medicine Physician	68924	GA

General Provider Information

NPI Number	:	1477870020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CELESTE MILLER MD

Provider Business Mailing Address
First Line	:	3699 CASCADE RD SW
Second Line	:	SUITE B2
City	:	ATLANTA
State	:	GA
Zip	:	30331-2163
Country	:	US
Telephone Number	:	404-691-7006
Fax Number	:	404-629-9498

Provider Business Practice Location Address
First Line	:	3699 CASCADE RD SW
Second Line	:	SUITE B1
City	:	ATLANTA
State	:	GA
Zip	:	30331-2163
Country	:	US
Telephone Number	:	404-691-7006
Fax Number	:	404-629-9498

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

Provider Enumeration Date	:	04/22/2010
Last Update Date	:	11/05/2015

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