Basic Information
Provider Information
NPI: 1811984263
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLER
FirstName: DREW
MiddleName: V.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5671 PEACHTREE DUNWOODY RD NE
Address2: SUITE 900
City: ATLANTA
State: GA
PostalCode: 303425000
CountryCode: US
TelephoneNumber: 4048479999
FaxNumber: 4045318466
Practice Location
Address1: 5671 PEACHTREE DUNWOODY RD NE
Address2: SUITE 900
City: ATLANTA
State: GA
PostalCode: 303425000
CountryCode: US
TelephoneNumber: 4048479999
FaxNumber: 4045318466
Other Information
ProviderEnumerationDate: 09/30/2005
LastUpdateDate: 03/28/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X033405GAY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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