Provider Demographics
NPI:1093753345
Name:MILLER, DAVID WAYNE SR (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WAYNE
Last Name:MILLER
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:1115 BOULDERS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-4067
Practice Address - Country:US
Practice Address - Phone:804-320-1339
Practice Address - Fax:804-330-5829
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2020-09-12
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Provider Licenses
StateLicense IDTaxonomies
VA0101045888207XS0114X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1093753345Medicaid
VA200035192OtherRAILROAD MEDICARE
VA0900834OtherUNITED HEALTHCARE
VA2214891OtherAETNA HMO
VA288507OtherSOUTHERN HEALTH
VA540885859OtherCIGNA
VA540885859OtherPRIVATE HEALTHCARE SYSTEM
VA17552OtherSH CARENET
VA2138283OtherUNITED HEALTHCARE MAMSI
VA23501OtherOPTIMA HEALTH
VA386536OtherANTHEM WEST END OPERATORY
VA540885859OtherCORVEL
VA226981OtherANTHEM HEALTHKEEPERS
VA540885859OtherFIRST HEALTH/CCN
VA540885859OtherC&O EMPLOYEES HEALTHCARE
VA540885859OtherCOMPMANAGEMENT
VA006407587Medicaid
VA540885859OtherFOCUS
VA17552OtherSH CARENET
VA23501OtherOPTIMA HEALTH
VA0472640006Medicare NSC