Provider Demographics
NPI:1851404883
Name:MILLER, ANDREW O (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:O
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 1:31300 REXWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1464
Mailing Address - Country:US
Mailing Address - Phone:248-932-0200
Mailing Address - Fax:248-932-0286
Practice Address - Street 1:31300 REXWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1464
Practice Address - Country:US
Practice Address - Phone:248-932-0200
Practice Address - Fax:248-932-0286
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAM003046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950F35121OtherBCBS
MI950F35121OtherBCBS