Provider Demographics
NPI:1427943612
Name:MILLER, ALVIN II (CCHW)
Entity type:Individual
Prefix:MR
First Name:ALVIN
Middle Name:
Last Name:MILLER
Suffix:II
Gender:M
Credentials:CCHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13942 SAINT MARYS ST APT 1
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-1724
Mailing Address - Country:US
Mailing Address - Phone:313-612-0878
Mailing Address - Fax:
Practice Address - Street 1:12841 E MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-3343
Practice Address - Country:US
Practice Address - Phone:313-612-0878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI142899736172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker