MEDICARE: ROBERT L MILLER M.D.

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	036-085262	IL

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	:	1902835226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT L MILLER M.D.

Provider Business Mailing Address
First Line	:	3331 W DEYOUNG ST
Second Line	:	STE 109
City	:	MARION
State	:	IL
Zip	:	62959-5896
Country	:	US
Telephone Number	:	618-998-7239
Fax Number	:	618-998-7248

Provider Business Practice Location Address
First Line	:	3331 W DEYOUNG ST
Second Line	:	STE 109
City	:	MARION
State	:	IL
Zip	:	62959-5896
Country	:	US
Telephone Number	:	618-998-7239
Fax Number	:	618-998-7248

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	01/06/2009

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