Provider Demographics
NPI:1780755215
Name:MILLER, ISAAC HENRY III (MD)
Entity type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:HENRY
Last Name:MILLER
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:270 SMITH CHURCH ROAD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-4914
Mailing Address - Country:US
Mailing Address - Phone:252-537-0134
Mailing Address - Fax:252-537-6515
Practice Address - Street 1:270 SMITH CHURCH RD
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4914
Practice Address - Country:US
Practice Address - Phone:252-537-0134
Practice Address - Fax:252-537-6515
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC32539207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0455334OtherUNITED HEALTHCARE
18619OtherCAPITOL BC PENN
NC59024OtherBCBSNC
110074906OtherRAILROAD MEDICARE PALMETT
6068995OtherVIRGINIA MEDICAID
VA028182OtherBCBSVA
1435956HALIOtherUNITED MINE WORKERS
203849OtherDIVISION OF COAL MINERS
47699OtherMEDCOST
NC8959024Medicaid
203849OtherDIVISION OF COAL MINERS
6068995OtherVIRGINIA MEDICAID