Provider Demographics
NPI:1952349722
Name:MILLER, JAMES WESLEY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WESLEY
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 1:13441 STONEGATE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-3961
Mailing Address - Country:US
Mailing Address - Phone:804-330-3335
Mailing Address - Fax:804-330-9205
Practice Address - Street 1:3742 WINTERFIELD RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-9238
Practice Address - Country:US
Practice Address - Phone:804-330-3335
Practice Address - Fax:804-330-9205
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101030576207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA080070225OtherMEDICARE RAILROAD
080004654Medicare PIN
VA0914020001Medicare NSC
VAF02409Medicare UPIN