Provider Demographics
NPI:1851305320
Name:MILLER, DAVID J (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:MILLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:201 WOOLSTON DRIVE
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067
Mailing Address - Country:US
Mailing Address - Phone:215-736-2508
Mailing Address - Fax:215-736-0744
Practice Address - Street 1:201 WOOLSTON DRIVE
Practice Address - Street 2:SUITE 1E
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067
Practice Address - Country:US
Practice Address - Phone:215-736-2508
Practice Address - Fax:215-736-0744
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS003138L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001799884001Medicaid
PA104046Medicare PIN
PA30106Medicare UPIN