Provider Demographics
NPI:1790757458
Name:MILLER, GEORGE C II (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:C
Last Name:MILLER
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 HOSPITAL DR STE 306
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9350
Mailing Address - Country:US
Mailing Address - Phone:570-522-4144
Mailing Address - Fax:570-768-3911
Practice Address - Street 1:3 HOSPITAL DR STE 312
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-8909
Practice Address - Country:US
Practice Address - Phone:570-523-8700
Practice Address - Fax:570-523-8705
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2018-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD020608E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009985150002Medicaid
PA0009985150002Medicaid
PA024678Medicare PIN