Provider Demographics
NPI:1356484943
Name:MILLER, TERRY PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:PHILIP
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:261 HAMILTON AVE STE 401
Mailing Address - Street 2:SUITE 401
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2536
Mailing Address - Country:US
Mailing Address - Phone:650-326-2021
Mailing Address - Fax:650-363-2605
Practice Address - Street 1:261 HAMILTON AVE STE 401
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2536
Practice Address - Country:US
Practice Address - Phone:650-326-2021
Practice Address - Fax:650-363-2605
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG320722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44991Medicare UPIN