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NPI Code Detail

MEDICARE: GERALD MILLER M.D.

MEDICARE: GERALD MILLER M.D.
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
1208000000XPediatrics Physician125.068177IL

General Provider Information

NPI Number : 1508217118
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERALD MILLER M.D.
Provider Business Mailing Address
First Line : PO BOX 19635
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62794-9635
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 301 N 8TH ST STE 4A
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62701-1013
Country : US
Telephone Number : 217-545-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2016
Last Update Date : 06/24/2016

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Directions to “ GERALD MILLER M.D.” Practice Location

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