Provider Demographics
NPI:1740286772
Name:MILLER, DAVID GLENN (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:GLENN
Last Name:MILLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1971 BLUE FOX DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5505
Mailing Address - Country:US
Mailing Address - Phone:610-222-0837
Mailing Address - Fax:610-222-0838
Practice Address - Street 1:770 SUMNEYTOWN PIKE
Practice Address - Street 2:WP39-250
Practice Address - City:WEST POINT
Practice Address - State:PA
Practice Address - Zip Code:19486-0004
Practice Address - Country:US
Practice Address - Phone:215-652-2600
Practice Address - Fax:215-652-2607
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD10552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist