Doctor Name: | GARY JAMES MILLER |
NPI Number: | 1588866818 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 22318 |
Business Practice Address: | 101 Stadium Dr Morgantown, WV - 265067911 |
Business Phone Number: | 3045986871 |
Business Fax Number: | |
Mailing Address: | Po Box 897, MORGANTOWN |
State: | WV |
Postal Code: | 265070897 |
Phone Number: | 3042937401 |
Fax Number: | 3042936963 |
NPI Enumeration Date: | 05/31/2007 |
NPI Last Update Date: | 11/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 22318 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |