Provider Demographics
NPI:1831107424
Name:MILLER, DANIEL S (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:S
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5471 GEORGETOWN RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-5793
Mailing Address - Country:US
Mailing Address - Phone:317-297-0661
Mailing Address - Fax:317-328-6338
Practice Address - Street 1:8615 US 31 S STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-0972
Practice Address - Country:US
Practice Address - Phone:317-888-0560
Practice Address - Fax:317-888-0657
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07001020A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200851550Medicaid
IN521880NMedicare PIN
IN0812540001Medicare NSC
IN200851550Medicaid
INV11811Medicare PIN
INP00437259Medicare PIN