Provider Demographics
NPI:1740668631
Name:MILLER, JUSTIN MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:MICHAEL
Last Name:MILLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:570-645-1835
Mailing Address - Fax:570-645-1471
Practice Address - Street 1:120 PINE ST
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252-1409
Practice Address - Country:US
Practice Address - Phone:570-645-1835
Practice Address - Fax:570-645-1471
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS022375207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery