Provider Demographics
NPI:1235136367
Name:MILLER, NORMAN D (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:D
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 1:62 BROWN STREET,
Mailing Address - Street 2:SUITE 503
Mailing Address - City:HAVENHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830
Mailing Address - Country:US
Mailing Address - Phone:978-521-3681
Mailing Address - Fax:978-521-3682
Practice Address - Street 1:62 BROWN STREET,
Practice Address - Street 2:SUITE 503
Practice Address - City:HAVENHILL
Practice Address - State:MA
Practice Address - Zip Code:01830
Practice Address - Country:US
Practice Address - Phone:978-521-3681
Practice Address - Fax:978-521-3682
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD23142207RG0100X
NH8574207RG0100X
MA55638207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1235136367Medicaid
MA3027520Medicaid
J06941Medicare ID - Type Unspecified