1902902034 NPI number — DR. ALAN N MILLER MD

Table of content: DR. ALAN N MILLER MD (NPI 1902902034)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902902034 NPI number — DR. ALAN N MILLER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLER
Provider First Name:
ALAN
Provider Middle Name:
N
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902902034
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1930 MARLTON PIKE E
Provider Second Line Business Mailing Address:
Q-32
Provider Business Mailing Address City Name:
CHERRY HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08003-2150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-751-4108
Provider Business Mailing Address Fax Number:
856-810-9688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1930 MARLTON PIKE E
Provider Second Line Business Practice Location Address:
Q 32
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08003-2150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-751-4108
Provider Business Practice Location Address Fax Number:
856-810-9688
Provider Enumeration Date:
09/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  25MA04545000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4460324 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2051559000 . This is a "IBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com