Basic Information
| Provider Information | |||||||||
| NPI: | 1275767527 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ROBERT E MILLER OD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5393 POST RD | ||||||||
| Address2: | |||||||||
| City: | EAST GREENWICH | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028183023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018846066 | ||||||||
| FaxNumber: | 4018852142 | ||||||||
| Practice Location | |||||||||
| Address1: | 5393 POST RD | ||||||||
| Address2: | |||||||||
| City: | EAST GREENWICH | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028183023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018846066 | ||||||||
| FaxNumber: | 4018852142 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2009 | ||||||||
| LastUpdateDate: | 05/14/2009 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4018846066 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | OD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.