Provider Demographics
NPI:1407903156
Name:MILLER, WESTON PETER IV (MD)
Entity Type:Individual
Prefix:DR
First Name:WESTON
Middle Name:PETER
Last Name:MILLER
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:PEDIATRIC HEMATOLOGY-ONCOLOGY MAYO MAIL CODE 484
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-626-2778
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE SE
Practice Address - Street 2:EAST BUILDING JOURNEY CLINIC 9E
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454
Practice Address - Country:US
Practice Address - Phone:612-365-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN1049202080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology