| Doctor Name: | DR. MARK LOUIS MILLER |
| NPI Number: | 1124191333 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 00610 |
| Business Practice Address: | 8008 Westpark Dr Kaiser Permanente Tysons Corner Medical Center Mc Lean, VA - 221023109 |
| Business Phone Number: | 7032876400 |
| Business Fax Number: | |
| Mailing Address: | 2101 E Jefferson St, Kaiser Permanente Medicare Enrollment ROCKVILLE |
| State: | MD |
| Postal Code: | 208524908 |
| Phone Number: | 3018162424 |
| Fax Number: | |
| NPI Enumeration Date: | 11/16/2006 |
| NPI Last Update Date: | 12/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 00610 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |