Provider Demographics
NPI:1447221650
Name:MILLER, THOMAS S (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:S
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 MAIDEN CHOICE LN
Mailing Address - Street 2:SUITE # 204
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5911
Mailing Address - Country:US
Mailing Address - Phone:410-744-6566
Mailing Address - Fax:
Practice Address - Street 1:724 MAIDEN CHOICE LN
Practice Address - Street 2:SUITE # 204
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5911
Practice Address - Country:US
Practice Address - Phone:410-744-6566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD30272208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5944TSOtherCAREFIRST MARYLAND #
P00063942OtherRAILROAD MEDICARE #
MDE097OtherBLUECHOICE #
MD440021600Medicaid
MDE00540Medicare UPIN
MDE097OtherBLUECHOICE #