Provider Demographics
NPI:1093777518
Name:MILLER, JOANNE M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:M
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 1:1935 E 47TH PL
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-1268
Mailing Address - Country:US
Mailing Address - Phone:563-349-7829
Mailing Address - Fax:
Practice Address - Street 1:1351 W CENTRAL PARK AVE STE 1225
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-1889
Practice Address - Country:US
Practice Address - Phone:563-421-1585
Practice Address - Fax:563-421-1595
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA30804207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine