Provider Demographics
NPI:1386142867
Name:MILLER, MICHAEL HARRELL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HARRELL
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 VALLEJO CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-1438
Mailing Address - Country:US
Mailing Address - Phone:843-625-0853
Mailing Address - Fax:
Practice Address - Street 1:2571 FOREST DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2029
Practice Address - Country:US
Practice Address - Phone:803-254-2376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2020-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37052183500000X
GA029684183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist