Provider Demographics
NPI:1912084807
Name:ALLERGY, ASTHMA & IMMUNOLOGY, PC
Entity Type:Organization
Organization Name:ALLERGY, ASTHMA & IMMUNOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-588-8508
Mailing Address - Street 1:7205 ROTHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7415
Mailing Address - Country:US
Mailing Address - Phone:865-588-8508
Mailing Address - Fax:865-588-8057
Practice Address - Street 1:1114 E WEISGARBER RD
Practice Address - Street 2:STE A
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909
Practice Address - Country:US
Practice Address - Phone:865-588-1833
Practice Address - Fax:865-588-8057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN68256OtherBLUE CROSS-BLUE SHIELD
TN31655207Medicaid
TN3384710Medicare ID - Type Unspecified