Basic Information
| Provider Information | |||||||||
| NPI: | 1982672176 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | EFREM | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 29338 | ||||||||
| Address2: | DEPT 1010 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808447100 | ||||||||
| FaxNumber: | 4805125486 | ||||||||
| Practice Location | |||||||||
| Address1: | 2421 E SOUTHERN AVE | ||||||||
| Address2: | STE 7 | ||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852827612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804252160 | ||||||||
| FaxNumber: | 4803518797 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 12/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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| NPICertificationDate: | 12/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 17606 | AZ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.