Provider Demographics
NPI:1811983208
Name:MILLER, EWING MACROY (DC)
Entity type:Individual
Prefix:
First Name:EWING
Middle Name:MACROY
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:174 HOPWOOD-COOLSPRING ROAD
Mailing Address - City:HOPWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15445-0086
Mailing Address - Country:US
Mailing Address - Phone:724-437-9849
Mailing Address - Fax:724-437-8952
Practice Address - Street 1:174 HOPWOOD COOLSPRING RD
Practice Address - Street 2:
Practice Address - City:HOPWOOD
Practice Address - State:PA
Practice Address - Zip Code:15445-2225
Practice Address - Country:US
Practice Address - Phone:724-437-9849
Practice Address - Fax:724-437-8952
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-006922-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA017938080004Medicaid
PA29373OtherHIGHMARK
PA004638Medicare ID - Type Unspecified
PA017938080004Medicaid