Provider Demographics
NPI:1841210473
Name:MILLER, ERIC E (DC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:E
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 SUNBURY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9795
Mailing Address - Country:US
Mailing Address - Phone:740-369-4349
Mailing Address - Fax:740-369-3290
Practice Address - Street 1:575 SUNBURY RD
Practice Address - Street 2:SUITE A
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-9795
Practice Address - Country:US
Practice Address - Phone:740-369-4349
Practice Address - Fax:740-369-3290
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2321111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0307135Medicaid
OH0857031Medicare PIN
OHU72026Medicare UPIN