Miller, Mark Ian

Miller, Mark Ian is an individual health care provider with primary practice located at 570 South Ave E Bldg A , Cranford NJ 07016-3266. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Miller, Mark Ian can be contacted via phone (908) 603-4200.

Contact Information

Primary practice address
570 South Ave E Bldg A Cranford NJ 07016-3266
Phone: (908) 603-4200
Fax: (908) 497-1633
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 25MA06548700 New Jersey
Allopathic & Osteopathic Physicians / Urology 208800000X 25MA06548700 New Jersey

Profile Details

NPI number 1144219791
LBN Legal business name Miller, Mark Ian
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Mar 7th, 2022 - about 2 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 1144219791 NPPES
New Jersey MEDICAID 7277300

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