Doctor Name: | MR. RONALD K. MILLER |
NPI Number: | 1407957194 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RPA-C |
License Number: | 002767-1 |
Business Practice Address: | 21 N Main St Middleport, NY - 141051027 |
Business Phone Number: | 7167357774 |
Business Fax Number: | 7167353036 |
Mailing Address: | 33 N Main St, MIDDLEPORT |
State: | NY |
Postal Code: | 141051040 |
Phone Number: | 7167353735 |
Fax Number: | 7167353036 |
NPI Enumeration Date: | 09/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 002767-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |