Provider Demographics
NPI:1205882099
Name:MILLER, ANTHONY E (DPM)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:E
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3731 GUION RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-7604
Mailing Address - Country:US
Mailing Address - Phone:317-931-0664
Mailing Address - Fax:317-927-0924
Practice Address - Street 1:3731 GUION RD
Practice Address - Street 2:SUITE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-7604
Practice Address - Country:US
Practice Address - Phone:317-924-6241
Practice Address - Fax:317-924-4787
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000416A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100226840Medicaid
IN6332990001Medicare NSC
IN4685310001Medicare NSC
INT35039Medicare UPIN
IN100226840Medicaid
IN192530AMedicare PIN
IN480034682Medicare PIN