Provider Demographics
NPI:1588132385
Name:MILLER, CHRISTOPHER ANDREW (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANDREW
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 1:1709 WOODLANDS WAY SE
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-7680
Mailing Address - Country:US
Mailing Address - Phone:661-803-6635
Mailing Address - Fax:
Practice Address - Street 1:1201 11TH AVE SW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4207
Practice Address - Country:US
Practice Address - Phone:208-288-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-09
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9524794-1701333600000X
IDP81353336L0003X
NDRL21253207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy