Provider Demographics
NPI:1538519699
Name:MILLER, ANDREW
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 S PATTEN RD
Mailing Address - Street 2:
Mailing Address - City:PATTEN
Mailing Address - State:ME
Mailing Address - Zip Code:04765-3007
Mailing Address - Country:US
Mailing Address - Phone:075-383-7002
Mailing Address - Fax:207-528-2880
Practice Address - Street 1:180 MAIN RD
Practice Address - Street 2:
Practice Address - City:BROWNVILLE
Practice Address - State:ME
Practice Address - Zip Code:04414-3107
Practice Address - Country:US
Practice Address - Phone:207-538-3700
Practice Address - Fax:207-528-2880
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPOD1126213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery