Provider Demographics
NPI:1265425813
Name:MILLER, ANDREW BENTON (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:BENTON
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:207 N BUTTE ST
Mailing Address - Street 2:
Mailing Address - City:WILLOWS
Mailing Address - State:CA
Mailing Address - Zip Code:95988-2803
Mailing Address - Country:US
Mailing Address - Phone:530-934-6980
Mailing Address - Fax:530-934-4081
Practice Address - Street 1:207 N BUTTE ST
Practice Address - Street 2:
Practice Address - City:WILLOWS
Practice Address - State:CA
Practice Address - Zip Code:95988-2803
Practice Address - Country:US
Practice Address - Phone:530-934-6980
Practice Address - Fax:530-934-4081
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2012-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA73321207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G72892Medicare UPIN