Provider Demographics
NPI:1013204072
Name:MILLER, JUSTIN GRIFFITH (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:GRIFFITH
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF GENERAL SURGERY
Mailing Address - Street 2:8901 WISCONSIN AVE
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0001
Mailing Address - Country:US
Mailing Address - Phone:205-908-0182
Mailing Address - Fax:
Practice Address - Street 1:LOYOLA DEPARTMENT OF CARDIOTHORACIC SURGERY
Practice Address - Street 2:2160 S. 1ST. AVENUE
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153
Practice Address - Country:US
Practice Address - Phone:888-584-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.159350208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery