Provider Demographics
NPI:1518688738
Name:MILLER, ROBERT JUSTIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JUSTIN
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 131
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:MD
Mailing Address - Zip Code:21869-0131
Mailing Address - Country:US
Mailing Address - Phone:443-521-3238
Mailing Address - Fax:
Practice Address - Street 1:404B WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2810
Practice Address - Country:US
Practice Address - Phone:410-221-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28791183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist