Provider Demographics
NPI:1528036936
Name:MILLER, GRAYSON B JR (MD)
Entity Type:Individual
Prefix:
First Name:GRAYSON
Middle Name:B
Last Name:MILLER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:109 GOVERNOR ST
Mailing Address - Street 2:ROOM 644B
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-3623
Mailing Address - Country:US
Mailing Address - Phone:804-864-7899
Mailing Address - Fax:804-864-7902
Practice Address - Street 1:109 GOVERNOR ST
Practice Address - Street 2:ROOM 644B
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-3623
Practice Address - Country:US
Practice Address - Phone:804-864-7899
Practice Address - Fax:804-864-7902
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101019918207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease