Miller, Mark
Miller, Mark is an individual health care provider with primary practice located at 200 Jefferson Ave Se , Grand Rapids MI 49503-4502. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Miller, Mark can be contacted via phone (800) 968-6866.Contact Information
Primary practice address
200 Jefferson Ave Se
Grand Rapids MI 49503-4502
Phone: (800) 968-6866
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 5101010914 | Michigan |
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | 010914 | Michigan |
Profile Details
| NPI number | 1447245501 |
|---|---|
| LBN Legal business name | Miller, Mark |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2005 |
| Last updated | May 1st, 2009 - about 15 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 | 1447245501 | NPPES |
| Michigan | Other | 930026760 | RAILROAD MEDICARE |
| Michigan | MEDICAID | 3169504 | RAILROAD MEDICARE |
| Michigan | Other | MM010914 | RAILROAD MEDICARE |
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