Provider Demographics
NPI:1316186646
Name:MILLER, MICHELE B IV (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:B
Last Name:MILLER
Suffix:IV
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 1:10123 SUMMIT VIEW POINTE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80126-5517
Mailing Address - Country:US
Mailing Address - Phone:303-470-7862
Mailing Address - Fax:
Practice Address - Street 1:6909 S HOLLY CIR STE 100
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-6300
Practice Address - Country:US
Practice Address - Phone:720-528-3559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33661207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine