| Doctor Name: | ROBERTO MILLER |
| NPI Number: | 1124159488 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 5601004786 |
| Business Practice Address: | 11 N Maple St Grant, MI - 493277900 |
| Business Phone Number: | 2318340444 |
| Business Fax Number: | |
| Mailing Address: | 1615 Michigan Ave, BALDWIN |
| State: | MI |
| Postal Code: | 493047984 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 12/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5601004786 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |