Provider Demographics
NPI:1215534599
Name:MILLER, MASON (PA-C)
Entity Type:Individual
Prefix:
First Name:MASON
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2494 BERNVILLE RD STE 207
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9467
Mailing Address - Country:US
Mailing Address - Phone:610-378-2676
Mailing Address - Fax:610-378-2679
Practice Address - Street 1:2494 BERNVILLE RD STE 207
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9467
Practice Address - Country:US
Practice Address - Phone:610-378-2676
Practice Address - Fax:610-378-2679
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical