Provider Demographics
NPI:1063456465
Name:MILLER, JOSEPH S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:S
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 1:1902 HARLAN DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-6602
Mailing Address - Country:US
Mailing Address - Phone:402-682-4165
Mailing Address - Fax:402-934-2291
Practice Address - Street 1:1902 HARLAN DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-6602
Practice Address - Country:US
Practice Address - Phone:402-682-4165
Practice Address - Fax:402-934-2291
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-48000207QH0002X
NE16501207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE092657Medicare UPIN
NE092657Medicare UPIN
NE0659310001OtherDMERC
NE47058329013Medicaid