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NPI Code Detail

MEDICARE: MRS. TIWANA L. MILLER PA-C

MEDICARE: MRS. TIWANA L. MILLER PA-C
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
1363A00000XPhysician AssistantC5-0000682DE

General Provider Information

NPI Number : 1649500760
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIWANA L. MILLER PA-C
Provider Business Mailing Address
First Line : 200 HYGEIA DR
Second Line : CCHS PHYSICIAN CONTRACTING, SUITE 2300
City : NEWARK
State : DE
Zip : 19713-2049
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 S. MAIN STREET
Second Line : SMYRNA HEALTH & WELLNESS CENTER, SUITE 207
City : SMYRNA
State : DE
Zip : 19977-1479
Country : US
Telephone Number : 302-659-4490
Fax Number : 302-659-4495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2010
Last Update Date : 05/10/2016

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