Provider Demographics
NPI:1013918218
Name:MILLER, LAURA MAY (DO)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MAY
Last Name:MILLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MEDICAL PARK
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6391
Mailing Address - Country:US
Mailing Address - Phone:304-243-7074
Mailing Address - Fax:304-243-6430
Practice Address - Street 1:20 MEDICAL PARK
Practice Address - Street 2:SUITE 301
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6391
Practice Address - Country:US
Practice Address - Phone:304-243-7074
Practice Address - Fax:304-243-6430
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV1845207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
001718177OtherMOUNTAIN STATE BCBS
WV3003077000Medicaid
WV55035705700OtherWV COMPENSATION
1845AOtherHEALTH PLAN OF UPPER OH V
OH2315622Medicaid
1845OtherHEALTH PLAN OF UPPER OH V
WV7299961Medicare PIN