Provider Demographics
NPI:1780783308
Name:MILLER, BRIAN FRANCIS (DO)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:FRANCIS
Last Name:MILLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01944-1139
Mailing Address - Country:US
Mailing Address - Phone:978-526-8084
Mailing Address - Fax:
Practice Address - Street 1:92 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01944-1139
Practice Address - Country:US
Practice Address - Phone:978-526-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9893207P00000X
MA55154207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3807876OtherAETNA HMO
MA733902OtherTUFTS
MAAA34382OtherHPHC
MAJ13346OtherHMO BLUE
MA3108252Medicaid
NHMI RE4445Medicare ID - Type Unspecified
MA3807876OtherAETNA HMO
MAJ13346OtherHMO BLUE