Provider Demographics
NPI:1902902034
Name:MILLER, ALAN N (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:N
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 MARLTON PIKE E
Mailing Address - Street 2:Q-32
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2150
Mailing Address - Country:US
Mailing Address - Phone:856-751-4108
Mailing Address - Fax:856-810-9688
Practice Address - Street 1:1930 MARLTON PIKE E
Practice Address - Street 2:Q 32
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2150
Practice Address - Country:US
Practice Address - Phone:856-751-4108
Practice Address - Fax:856-810-9688
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA045450002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4460324OtherAETNA
PA2051559000OtherIBC