Provider Demographics
NPI:1124013446
Name:MILLER, STUART J (MD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:J
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:50 NEW SCOTLAND AVE # MC-192
Mailing Address - Street 2:DIVISION OF CARDIO-THORACIC SURGERY
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3403
Mailing Address - Country:US
Mailing Address - Phone:518-262-9777
Mailing Address - Fax:518-262-9778
Practice Address - Street 1:50 NEW SCOTLAND AVE # MC-192
Practice Address - Street 2:DIVISION OF CARDIO-THORACIC SURGERY
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3403
Practice Address - Country:US
Practice Address - Phone:518-262-9777
Practice Address - Fax:518-262-9778
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2012-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY161824208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2014459Medicaid
NY011696999Medicaid
VT1004482Medicaid
NY020053298OtherRR MEDICARE
MA2014459Medicaid
NYDD3168Medicare PIN