Miller, Larry

Miller, Larry is an individual health care provider with primary practice located at 3401 N Broad St , Philadelphia PA 19140-5103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Miller, Larry can be contacted via phone (215) 707-9900.

Contact Information

Primary practice address
3401 N Broad St Philadelphia PA 19140-5103
Fax: (215) 707-3831
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MD042159L Pennsylvania

Profile Details

NPI number 1083601926
LBN Legal business name Miller, Larry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Jan 21st, 2010 - about 14 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 1083601926 NPPES
Pennsylvania MEDICAID 0012194740003

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