Provider Demographics
NPI:1093159972
Name:MILLER, VALENCIA ESTELL (MD)
Entity Type:Individual
Prefix:MRS
First Name:VALENCIA
Middle Name:ESTELL
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-1929
Mailing Address - Country:US
Mailing Address - Phone:781-263-0033
Mailing Address - Fax:781-263-9125
Practice Address - Street 1:30 WASHINGTON ST
Practice Address - Street 2:ABOUT WOMEN BY WOMEN
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481
Practice Address - Country:US
Practice Address - Phone:781-263-0033
Practice Address - Fax:781-263-9125
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA271200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty