Provider Demographics
NPI:1427287127
Name:MILLER, BENJAMIN JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:JOSEPH
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:501 N COLUMBIA RD STOP 9037
Mailing Address - Street 2:UNIVERSITY OF NORTH DAKOTA SURGERY, SMHS RM 5108
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58203-9037
Mailing Address - Country:US
Mailing Address - Phone:701-777-3067
Mailing Address - Fax:701-777-2609
Practice Address - Street 1:501 N COLUMBIA RD STOP 9037
Practice Address - Street 2:UNIVERSITY OF NORTH DAKOTA SURGERY, SMHS RM 5108
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58203-9037
Practice Address - Country:US
Practice Address - Phone:701-777-3067
Practice Address - Fax:701-777-2609
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NDTRL11284208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery