Provider Demographics
NPI:1275626137
Name:MILLER, RICHARD P (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
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 1:6455 SW NYBERG LN
Mailing Address - Street 2:A109
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-9704
Mailing Address - Country:US
Mailing Address - Phone:503-692-1212
Mailing Address - Fax:
Practice Address - Street 1:6455 SW NYBERG LN
Practice Address - Street 2:A109
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9704
Practice Address - Country:US
Practice Address - Phone:503-692-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD10673207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G66994Medicare UPIN
HIH53666Medicare PIN