Provider Demographics
NPI:1992749543
Name:MILLER, JEFFREY E (DPM)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:E
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 DEKALB ST
Mailing Address - Street 2:UNIT 6B
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3434
Mailing Address - Country:US
Mailing Address - Phone:610-275-3555
Mailing Address - Fax:610-275-5305
Practice Address - Street 1:1340 DEKALB ST
Practice Address - Street 2:UNIT 6B
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3434
Practice Address - Country:US
Practice Address - Phone:610-275-3555
Practice Address - Fax:610-275-5305
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002189L213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0048265000OtherPERSONAL CHOICE/KHPE
PA0048265000OtherPERSONAL CHOICE/KHPE
PAMI161898Medicare ID - Type Unspecified