Miller, Kenneth Andrew

Miller, Kenneth Andrew is an individual health care provider with primary practice located at 611 Sherman Ave E , Fort Atkinson WI 53538-1960. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Miller, Kenneth Andrew can be contacted via phone (920) 568-6090.

Contact Information

Primary practice address
611 Sherman Ave E Fort Atkinson WI 53538-1960
Phone: (920) 568-6090
Fax: (920) 568-6083
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 11253504-1205 Utah
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X M-13495 Idaho
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 29654 Wisconsin

Profile Details

NPI number 1962543496
LBN Legal business name Miller, Kenneth Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2007
Last updated Mar 30th, 2020 - about 4 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 1962543496 NPPES
Wisconsin MEDICAID 1962543496

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