Provider Demographics
NPI:1912983115
Name:MILLER, ANNE J (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:J
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:668 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-1612
Mailing Address - Country:US
Mailing Address - Phone:617-202-5054
Mailing Address - Fax:617-202-5054
Practice Address - Street 1:60 HOSPITAL RD.
Practice Address - Street 2:U MASS HEALTH ALLIANCE LEOMINSTER CAMPUS
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453
Practice Address - Country:US
Practice Address - Phone:978-466-2000
Practice Address - Fax:978-466-2000
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA54834208VP0014X, 207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110045947AMedicaid
MAJ07024Medicare PIN
MA110045947AMedicaid