Provider Demographics
NPI:1467477901
Name:MILLER, CHAD MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:MICHAEL
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 1:5350 FRANTZ RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4259
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3555 OLENTANGY RIVER RD STE 2002
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3910
Practice Address - Country:US
Practice Address - Phone:614-533-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83260207T00000X, 2084N0400X, 208600000X
VA01012667092084N0400X
OH350984672084N0400X, 2084V0102X
NJ25MA093719002084N0400X
MI43011193042084N0400X
IL0361335492084N0400X
FLME1397292084N0400X
WI64970-202084N0400X
IN01086390A2084N0400X
CT673522084N0400X
NC2002-015032084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0064846Medicaid
CA00A832600Medicaid
CAH96869Medicare UPIN
CA00A832600Medicaid
OH0064846Medicaid
CAWA83260AMedicare PIN