Bart J Miller PA

NPI 1093979080 - Physician Assistant - 363A00000X

NPI Details
NPI 1093979080
Gender Male
Enumeration Date 07/18/2008
Last Updated 12/04/2014
Entity Type Individual
Active Over 8 years ago
Practice Location
704 S WEBSTER AVE
STE 100
GREEN BAY WI, 54301-3528, US
Phone (920) 433-3456
Fax
Business Location
PO BOX 22487
GREEN BAY WI, 54305-2487, US
Phone (920) 445-7210
Fax (920) 445-7289
Toxanomy
Taxonomy Code 363A00000X
License State Wisconsin
License Number 2310
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According to our database, Bart J Miller PA NPI is 1093979080, taxonomy code is 363A00000X and license number is 2310, license state is located at Wisconsin. Bart J Miller PA physically located at 704 S Webster Ave, Green Bay WI, 54301-3528. NPI Number Bart J Miller PA has the Individual type.

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1093979080 NPI number is provided on an as is basis without warranty of any kind. 1093979080 is maintained by the National Plan & Provider Enumeration System. The contents of Bart J Miller PA are for informational purposes only.