Active NPI
Robert Elliot Miller, M.D.
- Pediatrics Physician
- Waldorf, MD
National Provider Identifier
1811047087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0024265
- Practice address
- 11315 Pembrooke Square
Suite 110
Waldorf, MD 20603 - Phone
- (301) 843-6996
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D0024265 | MD | Primary |
Addresses
Primary practice location
11315 Pembrooke Square
Suite 110
Waldorf, MD 20603
Mailing address
11315 Pembrooke Square
Suite 110
Waldorf, MD 20603
Phone (301) 843-6996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0024265 | MD | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- rmiller548059@direct.umm.edu
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318809600000",
"number": "1811047087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11315 PEMBROOKE SQUARE",
"address_2": "SUITE 110",
"city": "WALDORF",
"state": "MD",
"postal_code": "20603",
"telephone_number": "301-843-6996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11315 PEMBROOKE SQUARE",
"address_2": "SUITE 110",
"city": "WALDORF",
"state": "MD",
"postal_code": "20603",
"telephone_number": "301-843-6996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ROBERT",
"middle_name": "ELLIOT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2011-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0024265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.