Provider Demographics
NPI:1275563686
Name:MILLER, DANA L (MD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5880 S HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:GLOBE
Mailing Address - State:AZ
Mailing Address - Zip Code:85501-9447
Mailing Address - Country:US
Mailing Address - Phone:928-425-3247
Mailing Address - Fax:928-425-3859
Practice Address - Street 1:750 HOSPITAL LOOP
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-8750
Practice Address - Country:US
Practice Address - Phone:970-824-9411
Practice Address - Fax:970-826-3116
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2024-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ40712208600000X
COCDRH.0060298208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ353553Medicaid
CO9000161438Medicaid
AZVM03006001Medicare PIN