Provider Demographics
NPI:1154381184
Name:MILLER, SCOTT D (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 QUAKERBRIDGE ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619
Mailing Address - Country:US
Mailing Address - Phone:609-394-3804
Mailing Address - Fax:609-989-1550
Practice Address - Street 1:3705 QUAKERBRIDGE ROAD
Practice Address - Street 2:SUITE 103
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-394-3804
Practice Address - Fax:609-989-1550
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ47450207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2016702Medicaid
NJ57401OtherAETNA
NJE22058Medicare UPIN
NJ470202A3GMedicare PIN