Provider Demographics
NPI:1194727487
Name:MILLER, PAUL DANIEL (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DANIEL
Last Name:MILLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 WOLF ACRES DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-2022
Mailing Address - Country:US
Mailing Address - Phone:301-334-4400
Mailing Address - Fax:301-334-8228
Practice Address - Street 1:69 WOLF ACRES DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-2022
Practice Address - Country:US
Practice Address - Phone:301-334-4400
Practice Address - Fax:301-334-8228
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2008-04-15
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-05
Provider Licenses
StateLicense IDTaxonomies
MDH0026154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0714801 00Medicaid
7969740OtherAETNA
257024OtherMAMSI
522071438OtherGREAT WEST
522071438OtherWELLS FARGO
522071438OtherCIGNA
063731961OtherMARYLAND PHYSICANS CARE
522071438OtherUNITED HEALTHCARE
6213PDOtherBLUECROSS/BLUESHIELD
522071438OtherONE NET
6213PDOtherBLUECROSS/BLUESHIELD
522071438OtherCIGNA