Provider Demographics
NPI:1841302288
Name:MILLER, STEPHEN S (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:S
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 440509
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0509
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6188
Practice Address - Street 1:1934 ALCOA HWY
Practice Address - Street 2:STE 474
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1524
Practice Address - Country:US
Practice Address - Phone:865-305-8780
Practice Address - Fax:865-305-8199
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD36462207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3877803Medicaid
TN3877803Medicaid
TNH69134Medicare UPIN
830008582Medicare PIN