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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558369215 NPPES
Connecticut MEDICAID 001361691

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