Provider Demographics
NPI:1740243823
Name:MILLER, RYAN VERN (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:VERN
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2209 S STERLING ST STE 530
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4093
Mailing Address - Country:US
Mailing Address - Phone:828-580-4230
Mailing Address - Fax:828-580-4239
Practice Address - Street 1:2209 S STERLING ST STE 530
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4093
Practice Address - Country:US
Practice Address - Phone:828-580-4230
Practice Address - Fax:828-580-4239
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601006207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8959345Medicaid
NC59345OtherBCBS OF NC PROVIDER ID#
NC8959345Medicaid
NC2227582CMedicare PIN