Provider Demographics
NPI:1114931607
Name:MILLER, LEONA ARICA (MD)
Entity Type:Individual
Prefix:
First Name:LEONA
Middle Name:ARICA
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 1:4705 UNIVERSITY DR BLDG 700
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3489
Mailing Address - Country:US
Mailing Address - Phone:919-748-4899
Mailing Address - Fax:866-538-4716
Practice Address - Street 1:815 OBERLIN RD STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1351
Practice Address - Country:US
Practice Address - Phone:919-322-4722
Practice Address - Fax:919-322-4729
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33797207Q00000X
NC2010-02124207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3703214Medicaid
E65736Medicare UPIN
TN3703214Medicaid