Provider Demographics
NPI:1932360856
Name:MILLER, KATHERINE JOYCE (OD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:JOYCE
Last Name:MILLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:JOYCE
Other - Last Name:SHUELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:105 PINE BLUFF RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7160
Mailing Address - Country:US
Mailing Address - Phone:410-749-1191
Mailing Address - Fax:410-749-6111
Practice Address - Street 1:10231 OLD OCEAN CITY BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-3566
Practice Address - Country:US
Practice Address - Phone:410-641-1744
Practice Address - Fax:410-641-3803
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2099152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist