Provider Demographics
NPI:1073505608
Name:MILLER, CYNTHIA D (DPM)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:D
Last Name:MILLER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8474 WINTON RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-4940
Mailing Address - Country:US
Mailing Address - Phone:513-728-4800
Mailing Address - Fax:513-728-4601
Practice Address - Street 1:8474 WINTON RD STE 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-4940
Practice Address - Country:US
Practice Address - Phone:513-728-4800
Practice Address - Fax:513-728-4601
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00304213E00000X
OH36003377213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2487465Medicaid
KY80000557Medicaid
KY80000557Medicaid
OH2487465Medicaid
KYP01076786Medicare PIN
OHP00893555Medicare PIN
OH4136611Medicare PIN
KY80000557Medicaid
OHP00127644OtherRAILROAD MEDICARE
OH2487465Medicaid
KY0172610001Medicare NSC
KY0664404Medicare PIN