Gerald E Miller, M.D.

Individual provider Active NPI Family Medicine Physician · Marietta, PA

NPI 1962488916 · NPPES record last updated Oct 29, 2007

Key facts

NPI
1962488916
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
MD019845E (PA)
Practice address
1159 River Rd
Marietta, PA 17547-1628
Phone
(717) 426-1131
Fax
(717) 426-2068
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD019845E PA Yes

Addresses

Primary practice location

1159 River Rd
Marietta, PA 17547-1628

Mailing address

1159 River Rd
Marietta, PA 17547-1628
Phone (717) 426-1131

Other identifiers

IdentifierTypeStateIssuer
007751OtherPAHIGHMARK BLUE SHIELD
P002638OtherPAGATEWAY HEALTH PLAN
34994 S1QKOtherPAGEISINGER HEALTH PLAN
5502498OtherPAAETNA NON-HMO
0006954000001MedicaidPA
01332001OtherPACAPITAL BLUE CROSS
535943OtherPAAETNA HMO
C30214OtherPAHEALTH ASSURANCE

Other providers in Marietta, PA

All providers in Marietta, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.