Provider Demographics
NPI:1508047960
Name:P DANIEL MILLER D.O., P.A.
Entity Type:Organization
Organization Name:P DANIEL MILLER D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:301-334-4400
Mailing Address - Street 1:69 WOLF ACRES DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-2046
Mailing Address - Country:US
Mailing Address - Phone:301-334-4400
Mailing Address - Fax:301-334-8228
Practice Address - Street 1:69 WOLF ACRES DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-2046
Practice Address - Country:US
Practice Address - Phone:301-334-4400
Practice Address - Fax:301-334-8228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0026154261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
063731961OtherMARYLAND PHYSICANS CARE
7969740OtherAETNA
MD119472787OtherNPI
257024OtherMAMSI
6213PDOtherBLUECROSS/BLUESHIELD
257024OtherMAMSI
=========OtherUNITED HEALTHCARE
7969740OtherAETNA
=========OtherCIGNA
=========OtherGREAT WEST
257024OtherMAMSI