Provider Demographics
NPI:1184730459
Name:MILLER, JEAN CORINNE (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:CORINNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1481 W 10TH ST
Mailing Address - Street 2:111- HO
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2803
Mailing Address - Country:US
Mailing Address - Phone:317-988-4101
Mailing Address - Fax:317-988-3243
Practice Address - Street 1:1481 W 10TH ST
Practice Address - Street 2:111- HO
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2803
Practice Address - Country:US
Practice Address - Phone:317-988-4101
Practice Address - Fax:317-988-3243
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2010-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01033798207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100327440Medicaid
INE06516Medicare UPIN