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NPI Code Detail

MEDICARE: DIANA ELIZABETH MILLER MD

MEDICARE: DIANA ELIZABETH 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
1390200000XStudent in an Organized Health Care Education/Training Program
22080P0205XPediatric Endocrinology Physician2018-02475NC

General Provider Information

NPI Number : 1962778266
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA ELIZABETH MILLER MD
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 201 QUEENS RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-3217
Country : US
Telephone Number : 704-316-5285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2012
Last Update Date : 10/26/2020

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