Provider Demographics
NPI:1316475742
Name:MILLER, ROBERT JACK HENRY (MD, FRCPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JACK HENRY
Last Name:MILLER
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Gender:M
Credentials:MD, FRCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:162 TUSCANY RAVINE CLOSE NW
Mailing Address - Street 2:
Mailing Address - City:CALGARY
Mailing Address - State:AB
Mailing Address - Zip Code:T3L 2Y6
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:162 TUSCANY RAVINE CLOSE NW
Practice Address - Street 2:
Practice Address - City:CALGARY
Practice Address - State:AB
Practice Address - Zip Code:T3L 2Y6
Practice Address - Country:CA
Practice Address - Phone:403-606-5553
Practice Address - Fax:403-944-2757
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA148528207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease