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NPI Code Detail

MEDICARE: RANDALL W. MILLER D.O.

MEDICARE:   RANDALL W. MILLER  D.O.
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
1207Q00000XFamily Medicine Physician35137NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10675510001OTHERNJDMERC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30675510001OTHERNJDME MAC

General Provider Information

NPI Number : 1740342575
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDALL W. MILLER D.O.
Provider Business Mailing Address
First Line : 1170 CLIFTON AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07013-3622
Country : US
Telephone Number : 973-472-0220
Fax Number : 973-779-5306
Provider Business Practice Location Address
First Line : 1170 CLIFTON AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07013-3622
Country : US
Telephone Number : 973-472-0220
Fax Number : 973-779-5306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2006
Last Update Date : 04/03/2008

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Directions to “ RANDALL W. MILLER D.O.” Practice Location

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