Provider Demographics
NPI:1346271640
Name:MILLER, REX WINDSOR (CP)
Entity Type:Individual
Prefix:MR
First Name:REX
Middle Name:WINDSOR
Last Name:MILLER
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 S LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5417
Mailing Address - Country:US
Mailing Address - Phone:810-720-2555
Mailing Address - Fax:810-720-2551
Practice Address - Street 1:2255 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-5417
Practice Address - Country:US
Practice Address - Phone:810-720-2555
Practice Address - Fax:810-720-2551
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI850B50516OtherBC/BS
MI4264132Medicaid
MI4264132Medicaid