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NPI Code Detail

MEDICARE: DR. ROGER DALE MILLER M.D.

MEDICARE:  DR. ROGER DALE 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
12085R0202XDiagnostic Radiology Physician021507TN

Other Identifiers

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

General Provider Information

NPI Number : 1639177314
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER DALE MILLER M.D.
Provider Business Mailing Address
First Line : PO BOX 3990
Second Line :
City : CLEVELAND
State : TN
Zip : 37320-3990
Country : US
Telephone Number : 423-479-6214
Fax Number : 423-614-4405
Provider Business Practice Location Address
First Line : 2370 N OCOEE ST
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3850
Country : US
Telephone Number : 423-479-6214
Fax Number : 423-614-4405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 10/14/2010

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Directions to “ DR. ROGER DALE MILLER M.D.” Practice Location

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