MEDICARE: DR. MARYSSA MARY CATHERINE MILLER MD

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	207R00000X	Internal Medicine Physician	MD500002778	DC

General Provider Information

NPI Number	:	1881338853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARYSSA MARY CATHERINE MILLER MD

Provider Business Mailing Address
First Line	:	3301 NEW MEXICO AVE NW STE 336
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-3612
Country	:	US
Telephone Number	:	202-362-4467
Fax Number	:	202-793-5447

Provider Business Practice Location Address
First Line	:	3301 NEW MEXICO AVE NW STE 336
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-3612
Country	:	US
Telephone Number	:	202-362-4467
Fax Number	:	202-793-5447

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

Provider Enumeration Date	:	04/25/2022
Last Update Date	:	09/07/2025

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