Provider Demographics
NPI:1255470720
Name:MILLER, DINAH (MD)
Entity Type:Individual
Prefix:DR
First Name:DINAH
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W 40TH ST
Mailing Address - Street 2:THE ROTUNDA SUITE 322
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2120
Mailing Address - Country:US
Mailing Address - Phone:410-852-8404
Mailing Address - Fax:410-664-4632
Practice Address - Street 1:711 W 40TH ST
Practice Address - Street 2:THE ROTUNDA SUITE 322
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2120
Practice Address - Country:US
Practice Address - Phone:410-852-8404
Practice Address - Fax:410-664-4632
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD392842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD205051000Medicaid
MD919QMedicare ID - Type Unspecified
MD168662YX3Medicare PIN