Provider Demographics
NPI:1639170814
Name:MILLER, STEVEN CHRISTIAN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:CHRISTIAN
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MAPLEWOOD AVE
Mailing Address - Street 2:GREENBRIER PHYSICIANS, INC
Mailing Address - City:RONCEVERTE
Mailing Address - State:WV
Mailing Address - Zip Code:24970-1334
Mailing Address - Country:US
Mailing Address - Phone:304-647-5115
Mailing Address - Fax:304-647-3006
Practice Address - Street 1:200 MAPLEWOOD AVE
Practice Address - Street 2:GREENBRIER PHYSICIANS, INC
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-1334
Practice Address - Country:US
Practice Address - Phone:304-647-5115
Practice Address - Fax:304-647-3006
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV11324207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV009726200Medicaid
WV55-0524324OtherIRS
WV55-0524324OtherMY BUSINESSTAX ID NUMBER FORMERLY 51-0616992 FOR MILLER ORTHOPAEDICS
WV55-0524324OtherMY BUSINESSTAX ID NUMBER FORMERLY 51-0616992 FOR MILLER ORTHOPAEDICS
WV0596273Medicare PIN