Basic Information
| Provider Information | |||||||||
| NPI: | 1023067733 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2075 GLENN MITCHELL DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234560179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7572529365 | ||||||||
| FaxNumber: | 7579627217 | ||||||||
| Practice Location | |||||||||
| Address1: | 2075 GLENN MITCHELL DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234560179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7572529365 | ||||||||
| FaxNumber: | 7579627217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2006 | ||||||||
| LastUpdateDate: | 01/06/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 01/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 0101053971 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | 0101053971 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 10010593 | 01 | VA | SHP OHP | OTHER | PAR | 01 | VA | FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY | OTHER | PAR | 01 | VA | CORVEL/CORVARE | OTHER | 239541 | 01 | VA | ANTHEM | OTHER | PAR | 01 | VA | AETNA | OTHER | 1023067733 | 05 | VA | MEDICAID | PAR | 01 | VA | VIRGINIA PREMIER HEALTH | OTHER | PAR | 01 | VA | CIGNA | OTHER | PAR | 01 | VA | MULTIPLAN | OTHER | 065CH | 01 | NC | BCBS | OTHER | PAR | 01 | VA | USA MANAGED CARE | OTHER | -001 | 01 | VA | TRICARE/CHAMPUS | OTHER | 005848466 | 05 | VA | MEDICAID | PAR | 01 | VA | VIRGINIA HEALTH NETWORK | OTHER | 216591 | 01 | VA | ANTHEM BCBS | OTHER | 27885 | 01 | VA | OPTIMA/SENTARA | OTHER | 479432 | 01 | UHC/MAMSI | OTHER | 89065CH | 05 | NC | MEDICAID |