Provider Demographics
NPI:1033398532
Name:MILLER, DREW WILSON (MD)
Entity Type:Individual
Prefix:DR
First Name:DREW
Middle Name:WILSON
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1928 ALCOA HWY
Mailing Address - Street 2:STE 209
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1504
Mailing Address - Country:US
Mailing Address - Phone:865-524-2547
Mailing Address - Fax:865-219-5070
Practice Address - Street 1:1928 ALCOA HWY
Practice Address - Street 2:STE 209
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1504
Practice Address - Country:US
Practice Address - Phone:865-524-2547
Practice Address - Fax:865-219-5070
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN45752207N00000X, 207ND0101X
NC142504207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1519855Medicaid