Miller, Thomas G

Miller, Thomas G is an individual health care provider with primary practice located at 86 Dartmouth St , Portland ME 04103-4808. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Miller, Thomas G can be contacted via phone (207) 773-7406.

Contact Information

Primary practice address
86 Dartmouth St Portland ME 04103-4808
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PS1042 Maine

Profile Details

NPI number 1720094477
LBN Legal business name Miller, Thomas G
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Mar 19th, 2009 - 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 1720094477 NPPES
Maine Other 035275 ANTHEM BC/BS PROVIDER ID
Maine MEDICAID 231050000 ANTHEM BC/BS PROVIDER ID

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