Provider Demographics
NPI:1093978355
Name:MILLER, SEAN MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:MATTHEW
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 1:6420 DUTCHMANS PKWY STE 380
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3355
Mailing Address - Country:US
Mailing Address - Phone:502-894-8441
Mailing Address - Fax:502-894-4453
Practice Address - Street 1:6420 DUTCHMANS PKWY STE 380
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3355
Practice Address - Country:US
Practice Address - Phone:502-894-8441
Practice Address - Fax:502-894-4453
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072297A207Y00000X
KY46261207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology