1700869583 NPI number — ANNA B MILLER MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700869583 NPI number — ANNA B MILLER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLER
Provider First Name:
ANNA
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TYUTYUNIKOV
Provider Other First Name:
ANNA
Provider Other Middle Name:
B
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700869583
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2639 BROWNSVILLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15227-2005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-881-4242
Provider Business Mailing Address Fax Number:
412-881-4252

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2639 BROWNSVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15227-2005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-881-4242
Provider Business Practice Location Address Fax Number:
412-881-4252
Provider Enumeration Date:
11/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  MD068149L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5196070001 . This is a "DMERC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7398123 . This is a "AETNA PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 392553 . This is a "NATIONAL VISION ASSOC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0017956700003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 210209 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 802378 . This is a "BLUE CROSS BLUE SHEILD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: PA68149 . This is a "VISION BENEFITS OF AMERIC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 118234 . This is a "HEALTH AM/AS/ADVANTRA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 6560257 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 102850 . This is a "UMWA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 49927 . This is a "DAVIS VISION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3737978 . This is a "AETNA HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com