Provider Demographics
NPI:1831288430
Name:MILLER, DANIEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:61 WHITCHER ST NE
Mailing Address - Street 2:SUITE 4120
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1176
Mailing Address - Country:US
Mailing Address - Phone:770-424-9732
Mailing Address - Fax:770-421-0228
Practice Address - Street 1:61 WHITCHER ST NE
Practice Address - Street 2:SUITE 4120
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1176
Practice Address - Country:US
Practice Address - Phone:770-424-9732
Practice Address - Fax:770-421-0228
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA051066208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000939078AMedicaid
GA000939078AMedicaid
GAF08223001Medicare UPIN