Provider Demographics
NPI:1861576043
Name:MILLER, MICHAEL D II (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:MILLER
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:22331 MISSION BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3911
Mailing Address - Country:US
Mailing Address - Phone:510-471-5907
Mailing Address - Fax:510-690-0703
Practice Address - Street 1:22331 MISSION BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3911
Practice Address - Country:US
Practice Address - Phone:510-471-5907
Practice Address - Fax:510-690-0703
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2016-01-26
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Provider Licenses
StateLicense IDTaxonomies
IL036-108831207V00000X, 207VG0400X
CA139329207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H96930Medicare UPIN
367830Medicare PIN