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NPI Code Detail

MEDICARE: DR. MICHAEL BRANDON MILLER M.D.

MEDICARE: DR. MICHAEL BRANDON 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
1207Q00000XFamily Medicine PhysicianM5381TX
2207Q00000XFamily Medicine Physician244420-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942334388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL BRANDON MILLER M.D.
Provider Business Mailing Address
First Line : 28 HIDDEN HARBOR WAY
Second Line :
City : WEBSTER
State : NY
Zip : 14580-1887
Country : US
Telephone Number : 585-698-6505
Fax Number :
Provider Business Practice Location Address
First Line : 4425 OLD RIDGE RD
Second Line :
City : WILLIAMSON
State : NY
Zip : 14589-9363
Country : US
Telephone Number : 315-483-3220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 05/13/2009

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