Provider Demographics
NPI:1174064703
Name:MILLER, ERIC BRUCE
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:BRUCE
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4336 HALLEY TER SE APT 4
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-5824
Mailing Address - Country:US
Mailing Address - Phone:202-562-6714
Mailing Address - Fax:
Practice Address - Street 1:2201 SAVANNAH ST SE APT 205
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7587
Practice Address - Country:US
Practice Address - Phone:202-610-2529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant