Provider Demographics
NPI:1851669063
Name:MILLER, DONALD R III
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:R
Last Name:MILLER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6175 SHAMROCK CT STE B
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-1200
Mailing Address - Country:US
Mailing Address - Phone:614-226-8792
Mailing Address - Fax:
Practice Address - Street 1:6175 SHAMROCK CT STE B
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-1200
Practice Address - Country:US
Practice Address - Phone:614-226-8792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03124761183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist