Provider Demographics
NPI:1932162930
Name:MILLER, ALAN MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:MICHAEL
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 1:994 OLD EAGLE SCHOOL RD STE 1017
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1802
Mailing Address - Country:US
Mailing Address - Phone:610-902-6092
Mailing Address - Fax:610-902-6081
Practice Address - Street 1:306 W LOGAN ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-2935
Practice Address - Country:US
Practice Address - Phone:610-275-6153
Practice Address - Fax:610-278-7709
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-013843E207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4088055OtherAETNA
78665OtherUNITED HEALTHCARE
PA0006413380001Medicaid
072327OtherHIGHMARK BLUE SHIELD
1817536OtherCIGNA
0045517000OtherINDEPENDENCE BLUE CROSS
072327Medicare ID - Type Unspecified
1817536OtherCIGNA
78665OtherUNITED HEALTHCARE