Provider Demographics
NPI:1215993027
Name:MILLER, THOMAS A (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1201 BROAD ROCK BLVD
Mailing Address - Street 2:SURGICAL SERVICE (112)
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249-0001
Mailing Address - Country:US
Mailing Address - Phone:804-675-5112
Mailing Address - Fax:804-675-5390
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:SURGICAL SERVICE (112)
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-675-5112
Practice Address - Fax:804-675-5390
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101227171208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA19384Medicare UPIN