Provider Demographics
NPI:1063072171
Name:MILLER, MORGAN (MD)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:DILLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2016 VADALABENE DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-6901
Mailing Address - Country:US
Mailing Address - Phone:618-288-2970
Mailing Address - Fax:
Practice Address - Street 1:2016 VADALABENE DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-6901
Practice Address - Country:US
Practice Address - Phone:618-288-2970
Practice Address - Fax:618-288-3572
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.166416207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty