Miller, Debra R
Miller, Debra R is an individual health care provider with primary practice located at 53 Granite St , New London CT 06320-5917. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Miller, Debra R can be contacted via phone (860) 447-1419.Contact Information
Primary practice address
53 Granite St
New London CT 06320-5917
Phone: (860) 447-1419
Fax: (860) 442-2604
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 036169 | Connecticut |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | 036169 | Connecticut |
Profile Details
| NPI number | 1558369215 |
|---|---|
| LBN Legal business name | Miller, Debra R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Jun 27th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558369215 | NPPES |
| Connecticut | MEDICAID | 001361691 |
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