Provider Demographics
NPI:1457655912
Name:MILLER, DONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
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 1:7411 US HIGHWAY 23 S
Mailing Address - Street 2:
Mailing Address - City:OSSINEKE
Mailing Address - State:MI
Mailing Address - Zip Code:49766-9592
Mailing Address - Country:US
Mailing Address - Phone:989-471-2595
Mailing Address - Fax:
Practice Address - Street 1:301 LONG RAPIDS RD
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1317
Practice Address - Country:US
Practice Address - Phone:989-356-2194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301031405207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine