MEDICARE: AMELIA G MILLER PA

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	363AS0400X	Surgical Physician Assistant	PA60800394	WA
2	207RB0002X	Obesity Medicine (Internal Medicine) Physician	PA-2165	ID

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	:	1760731921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMELIA G MILLER PA

Provider Business Mailing Address
First Line	:	505 S MOUNTAIN VIEW RD STE 3
Second Line	:
City	:	MOSCOW
State	:	ID
Zip	:	83843-9205
Country	:	US
Telephone Number	:	208-301-7896
Fax Number	:	208-883-4404

Provider Business Practice Location Address
First Line	:	505 S MOUNTAIN VIEW RD STE 3
Second Line	:
City	:	MOSCOW
State	:	ID
Zip	:	83843-9205
Country	:	US
Telephone Number	:	208-301-7896
Fax Number	:	208-883-4404

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

Provider Enumeration Date	:	09/04/2012
Last Update Date	:	06/11/2026

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Directions to “ AMELIA G MILLER PA” Practice Location

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