1881338853 NPI number — DR. MARYSSA MARY CATHERINE MILLER MD

Table of content: DR. MARYSSA MARY CATHERINE MILLER MD (NPI 1881338853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881338853 NPI number — DR. MARYSSA MARY CATHERINE MILLER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLER
Provider First Name:
MARYSSA
Provider Middle Name:
MARY CATHERINE
Provider Name Prefix Text:
DR.
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:
GILBERT
Provider Other First Name:
MARYSSA
Provider Other Middle Name:
MARY CATHERINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881338853
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3301 NEW MEXICO AVE NW STE 336
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20016-3612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-362-4467
Provider Business Mailing Address Fax Number:
202-793-5447

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3301 NEW MEXICO AVE NW STE 336
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20016-3612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-362-4467
Provider Business Practice Location Address Fax Number:
202-793-5447
Provider Enumeration Date:
04/25/2022

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: 207R00000X , with the licence number:  MD500002778 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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