MEDICARE: RHONDA M 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
1	363L00000X	Nurse Practitioner	50.002230	OH
2	363AM0700X	Medical Physician Assistant	2230	OH

General Provider Information

NPI Number	:	1760670954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA M MILLER PA-C

Provider Business Mailing Address
First Line	:	4535 DRESSLER RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2545
Country	:	US
Telephone Number	:	330-497-8490
Fax Number	:	330-244-0514

Provider Business Practice Location Address
First Line	:	4200 INTERCHANGE CORPORATE CENTER RD
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44128-5631
Country	:	US
Telephone Number	:	216-910-3800
Fax Number	:

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

Provider Enumeration Date	:	10/12/2007
Last Update Date	:	11/12/2008

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