Provider Demographics
NPI:1467721456
Name:MILLER, DAVID STEVEN (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:STEVEN
Last Name:MILLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3039 W PEORIA AVE
Mailing Address - Street 2:STE.C102-613
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-5212
Mailing Address - Country:US
Mailing Address - Phone:623-687-6786
Mailing Address - Fax:623-334-1389
Practice Address - Street 1:7773 W LIBBY ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8240
Practice Address - Country:US
Practice Address - Phone:623-687-6786
Practice Address - Fax:623-334-1389
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03206204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM