Provider Demographics
NPI:1922114396
Name:MILLER, MICHAEL LAWRENCE (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:LAWRENCE
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2480 S DOWNING ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5890
Mailing Address - Country:US
Mailing Address - Phone:303-777-5455
Mailing Address - Fax:303-777-1175
Practice Address - Street 1:2480 S DOWNING ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5890
Practice Address - Country:US
Practice Address - Phone:303-777-5455
Practice Address - Fax:303-777-1175
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO35289207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01352897Medicaid
CE6468Medicare ID - Type Unspecified
CO01352897Medicaid