| Organization Name: | WAYNE R MILLER MD |
| NPI Number: | 1093872038 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WAYNE R MILLER (OWNER) |
| Mailing Address: | 255 W Spruce St Shamokin |
| State: | PA US |
| Postal Code: | 178725811 |
| Phone Number: | 5706445050 |
| Fax Number: | 5706442378 |
| NPI Enumeration Date: | 01/02/2007 |
| NPI Last Update Date: | 01/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | MD042431L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |