Provider Demographics
NPI:1205803574
Name:MILLER, SHERI L (OD)
Entity type:Individual
Prefix:DR
First Name:SHERI
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SHERI
Other - Middle Name:L
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:4865 FRANK AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-7425
Mailing Address - Country:US
Mailing Address - Phone:330-494-1710
Mailing Address - Fax:330-494-5815
Practice Address - Street 1:4865 FRANK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7425
Practice Address - Country:US
Practice Address - Phone:330-494-1710
Practice Address - Fax:330-494-5815
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4302152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU 28931Medicare UPIN
OH0698941Medicare ID - Type Unspecified