MEDICARE: MARCUS RICHARD 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	208600000X	Surgery Physician	35076919	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518965474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS RICHARD MILLER MD

Provider Business Mailing Address
First Line	:	6075 E BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-5131
Country	:	US
Telephone Number	:	614-864-6363
Fax Number	:	614-864-2248

Provider Business Practice Location Address
First Line	:	5300 N MEADOWS DR
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2546
Country	:	US
Telephone Number	:	614-864-6363
Fax Number	:

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	01/11/2024

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