Provider Demographics
NPI:1356310320
Name:MILLER, DAVID SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4446 MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SNYDER
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4406
Mailing Address - Country:US
Mailing Address - Phone:716-204-0743
Mailing Address - Fax:716-204-0747
Practice Address - Street 1:4446 MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SNYDER
Practice Address - State:NY
Practice Address - Zip Code:14226-4406
Practice Address - Country:US
Practice Address - Phone:716-204-0743
Practice Address - Fax:716-204-0747
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008207-1111N00000X
MD01811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00020197301OtherUNIVERA
NYX008207-1OtherNOVA
NY5888597OtherAETNA
NY002242792OtherBLUE CROSS/BLUE SHIELD
NY161541806-03OtherPRISM
NY5804180OtherGHI
NY8890229OtherINDEPENDENT HEALTH
NY00020197301OtherUNIVERA