Miller, David L
Miller, David L is an individual health care provider with primary practice located at 505 E Grant St Ste 103, Macomb IL 61455-3352. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Miller, David L can be contacted via phone (309) 833-3536.Contact Information
Primary practice address
505 E Grant St Ste 103
Macomb IL 61455-3352
Phone: (309) 833-3536
Fax: (309) 836-5729
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036104354 | Illinois |
Profile Details
| NPI number | 1861497612 |
|---|---|
| LBN Legal business name | Miller, David L |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2005 |
| Last updated | Nov 10th, 2011 - 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 | 1861497612 | NPPES |
| Illinois | MEDICAID | 036104354 | |
| Illinois | Other | 110247080 | |
| Illinois | Other | 5532005 | |
| Illinois | Other | 067033 |
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