Provider Demographics
NPI:1255306932
Name:MILLER, CELESTE EILEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:EILEEN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4550 E 53RD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-3171
Mailing Address - Country:US
Mailing Address - Phone:563-332-2152
Mailing Address - Fax:563-332-2153
Practice Address - Street 1:4550 E 53RD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3171
Practice Address - Country:US
Practice Address - Phone:563-332-2152
Practice Address - Fax:563-332-2153
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2014-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA347742081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG20720Medicare UPIN