Provider Demographics
NPI:1508815606
Name:MILLER, ALAN BRAD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:BRAD
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3850 HOLCOMB BRIDGE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-5220
Mailing Address - Country:US
Mailing Address - Phone:770-458-8381
Mailing Address - Fax:770-458-7472
Practice Address - Street 1:3850 HOLCOMB BRIDGE RD STE 105
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-5220
Practice Address - Country:US
Practice Address - Phone:770-458-8381
Practice Address - Fax:770-458-7472
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036228207R00000X
GAGA036228207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF34127Medicare UPIN