Provider Demographics
NPI:1174772198
Name:MILLER, EVAN C (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:C
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14275 MIDWAY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3676
Mailing Address - Country:US
Mailing Address - Phone:972-934-4392
Mailing Address - Fax:610-271-4245
Practice Address - Street 1:895 SW 30TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-4887
Practice Address - Country:US
Practice Address - Phone:800-330-6770
Practice Address - Fax:954-633-3217
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA207ZP0102X207ZP0102X
FLME110421207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology