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NPI Code Detail

MEDICARE: JESSICA MILLER

MEDICARE: JESSICA MILLER
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 PhysicianR209561MD
2207QG0300XGeriatric Medicine (Family Medicine) PhysicianR209561MD

General Provider Information

NPI Number : 1922862283
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MILLER
Provider Business Mailing Address
First Line : 1328 SUDVALE RD
Second Line :
City : PIKESVILLE
State : MD
Zip : 21208-4113
Country : US
Telephone Number : 443-986-2896
Fax Number :
Provider Business Practice Location Address
First Line : 6701 N CHARLES ST
Second Line :
City : TOWSON
State : MD
Zip : 21204-6808
Country : US
Telephone Number : 443-849-3184
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2024
Last Update Date : 05/17/2026

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Directions to “ JESSICA MILLER ” Practice Location

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