Provider Demographics
NPI:1265416846
Name:MILLER, PAUL M (DO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:MILLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 820933
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-728-2000
Mailing Address - Fax:215-214-4119
Practice Address - Street 1:7600 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2442
Practice Address - Country:US
Practice Address - Phone:215-728-2000
Practice Address - Fax:215-214-4119
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS004829L208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0054269000OtherINDEPENDENCE BLUE CROSS
PAP00055488OtherRAILROAD MEDICARE
PA1509OtherBRAVO HEALTH
PA30008822OtherKEYSTONE MERCY HEALTH
PA544679OtherCOVENTRY HEALTH AMERICA
PA4576798OtherAETNA PPO
PA0002524501OtherAMERICHOICE
PA001005781Medicaid
PA114738OtherHIGHMARK BLUE SHIELD
PA3466018OtherAETNA HMO
PA001005781Medicaid
PA30008822OtherKEYSTONE MERCY HEALTH