Provider Demographics
NPI:1285695569
Name:MILLER, PATRICK S (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:S
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 1:11613 SHOSHONE WAY
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2630
Mailing Address - Country:US
Mailing Address - Phone:303-880-0466
Mailing Address - Fax:
Practice Address - Street 1:11613 SHOSHONE WAY
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2630
Practice Address - Country:US
Practice Address - Phone:303-880-0466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37285207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO92503233Medicaid
H32773Medicare UPIN
COC460588Medicare PIN