Provider Demographics
NPI:1164784757
Name:MILLER, DANIEL PHILLIP (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PHILLIP
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2607
Mailing Address - Country:US
Mailing Address - Phone:803-254-6114
Mailing Address - Fax:
Practice Address - Street 1:1516 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2607
Practice Address - Country:US
Practice Address - Phone:803-254-6114
Practice Address - Fax:803-254-7674
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC678213E00000X, 213E00000X
KS12-00409213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist