Provider Demographics
NPI:1205841640
Name:ADVANCED VEIN THERAPIES PLLC
Entity Type:Organization
Organization Name:ADVANCED VEIN THERAPIES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:H
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-344-9110
Mailing Address - Street 1:32000 NORTHWESTERN HWY STE 215
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1570
Mailing Address - Country:US
Mailing Address - Phone:248-344-9110
Mailing Address - Fax:248-702-0722
Practice Address - Street 1:25500 MEADOWBROOK RD STE 215
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1882
Practice Address - Country:US
Practice Address - Phone:248-344-9110
Practice Address - Fax:248-344-9111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010542862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301054286OtherJEFFREY MILLER MD LIC#
MI104905238Medicaid
MIF66032Medicare UPIN
MI0P35170Medicare PIN