Provider Demographics
NPI:1356369086
Name:MILLER, STANTON B (M D)
Entity type:Individual
Prefix:
First Name:STANTON
Middle Name:B
Last Name:MILLER
Suffix:
Gender:M
Credentials:M D
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Mailing Address - Street 1:11 INDUSTRIAL BLVD
Mailing Address - Street 2:PAOLI POINTE BUILDING, SUITE 103
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1632
Mailing Address - Country:US
Mailing Address - Phone:484-565-1293
Mailing Address - Fax:610-296-5437
Practice Address - Street 1:11 INDUSTRIAL BLVD
Practice Address - Street 2:PAOLI POINTE BUILDING, SUITE 103
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1632
Practice Address - Country:US
Practice Address - Phone:484-565-1293
Practice Address - Fax:610-296-5437
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2011-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMD025555E2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD025555EOtherMEDICAL LICENSE