Provider Demographics
NPI:1336180579
Name:MILLER, JOEL MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:MICHAEL
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 NORTHWESTERN DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3480
Mailing Address - Country:US
Mailing Address - Phone:860-242-6633
Mailing Address - Fax:860-286-8411
Practice Address - Street 1:2 NORTHWESTERN DR STE 300
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3480
Practice Address - Country:US
Practice Address - Phone:860-242-6633
Practice Address - Fax:860-286-8411
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT015926207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT01215926OtherCIGNA
KY0V7294OtherHCS/HEALTH NET
CTP2522185OtherOXFORD
CT010015926CT01OtherBCS/SHIELD CT
PA2045215OtherAETNA
CT053027OtherCONNECTICARE
PA0505863OtherAETNA
GA061216611OtherUNITED HEALTHCARE
CT053027OtherCONNECTICARE
CTB83536Medicare UPIN
GA061216611OtherUNITED HEALTHCARE