Provider Demographics
NPI:1356384754
Name:MILLER, SCOTT DOUGLAS MCCOSKEY (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:DOUGLAS MCCOSKEY
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 1:202 10TH ST SE STE 165
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2433
Mailing Address - Country:US
Mailing Address - Phone:319-297-2900
Mailing Address - Fax:
Practice Address - Street 1:202 10TH ST SE STE 165
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2433
Practice Address - Country:US
Practice Address - Phone:319-297-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20872207Q00000X, 207RH0003X, 207R00000X
IAR7186207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00732371OtherRR MEDICARE
IA26271OtherBCBS OF IA
IA0499616Medicaid
IAP00732371OtherRR MEDICARE
IA26271OtherBCBS OF IA
IAI0923235Medicare UPIN
IAH37702Medicare UPIN