| Doctor Name: | BERWIN RALPH MILLER |
| NPI Number: | 1598102337 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CNP |
| License Number: | COA 15623 |
| Business Practice Address: | 6011 Groveport Road Groveport, OH - 43125 |
| Business Phone Number: | 6143434783 |
| Business Fax Number: | 6148302024 |
| Mailing Address: | 6011 Groveport Rd, GROVEPORT |
| State: | OH |
| Postal Code: | 431251006 |
| Phone Number: | 6143434783 |
| Fax Number: | 6148302024 |
| NPI Enumeration Date: | 06/03/2013 |
| NPI Last Update Date: | 05/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | COA 15623 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |