Provider Demographics
NPI:1710944939
Name:MILLER, CHRISTOPHER T (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:T
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 1:600 18TH ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3231
Mailing Address - Country:US
Mailing Address - Phone:304-424-4650
Mailing Address - Fax:304-424-4681
Practice Address - Street 1:600 18TH ST
Practice Address - Street 2:SUITE 512
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3231
Practice Address - Country:US
Practice Address - Phone:304-424-4574
Practice Address - Fax:304-424-4429
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18376208000000X, 207RI0011X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0079893000Medicaid
OH2013501Medicaid
WV0797244Medicare PIN
G21807Medicare UPIN
WV0079893000Medicaid
WV0797245Medicare UPIN