Provider Demographics
NPI:1174795322
Name:MILLER, VICTORIA (MS)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3300
Mailing Address - Fax:704-295-3468
Practice Address - Street 1:6035 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3256
Practice Address - Country:US
Practice Address - Phone:704-295-3300
Practice Address - Fax:704-295-3468
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3975231H00000X
NC973237600000X
NC906231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC163U5OtherBCBSNC
SC30111354OtherSELECT HEALTH OF SC
SCSAN094Medicaid
NC7413329Medicaid
SC879864OtherWELLCARE OF SC
SCP01662998OtherRAILROAD MEDICARE
9166262OtherAENTA
NCP01044548OtherRAILROAD MEDICARE PTAN
NC6798431OtherCIGNA
SCQ416585874Medicare PIN
NC6798431OtherCIGNA