Provider Demographics
NPI:1134123656
Name:MILLER, MAURICE (MD)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:
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 1:15 COMMERCE RD
Mailing Address - Street 2:CONCENTRA, 3RD FLOOR
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-4549
Mailing Address - Country:US
Mailing Address - Phone:618-973-5017
Mailing Address - Fax:203-324-9400
Practice Address - Street 1:15 COMMERCE RD
Practice Address - Street 2:CONCENTRA, 3RD FLOOR
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-4549
Practice Address - Country:US
Practice Address - Phone:618-973-5017
Practice Address - Fax:203-324-9400
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049867207X00000X
NY261498-1207X00000X
IL036060200207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery