Provider Demographics
NPI:1578514477
Name:MILLER, STEPHEN L (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:L
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5292 COLLEGE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-2672
Mailing Address - Country:US
Mailing Address - Phone:801-281-4278
Mailing Address - Fax:801-281-5960
Practice Address - Street 1:5292 COLLEGE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-2672
Practice Address - Country:US
Practice Address - Phone:801-281-4278
Practice Address - Fax:801-281-5960
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2023-08-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT360531-1205207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT25-00453OtherUNITED HEALTH CARE
UT202083175OtherUHC MEDICARE COMPLETE
UT235735OtherALTIUS
UT107007155103OtherSELECT HEALTH
UT202083175OtherAETNA
UT202083175SLMOtherEDUCATORS MUTUAL
UT350135OtherDESERET MUTUAL BENEFITS
UTP00254258OtherRAILROAD MEDICARE
UTP00254258OtherRAILROAD MEDICARE
UT005791001Medicare ID - Type Unspecified