Provider Demographics
NPI:1851352942
Name:MILLER, SAMUEL B (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:B
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3807 TIMBER VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-1839
Mailing Address - Country:US
Mailing Address - Phone:443-903-0019
Mailing Address - Fax:
Practice Address - Street 1:1420 KEY HWY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5546
Practice Address - Country:US
Practice Address - Phone:410-230-7800
Practice Address - Fax:410-230-7801
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00411972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD083421100Medicaid
MD083421100Medicaid
F02930Medicare UPIN