Provider Demographics
NPI:1184610826
Name:MILLER, DWIGHT BEVERLEY (RPH)
Entity type:Individual
Prefix:MR
First Name:DWIGHT
Middle Name:BEVERLEY
Last Name:MILLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 PLANKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-2920
Mailing Address - Country:US
Mailing Address - Phone:540-869-7919
Mailing Address - Fax:
Practice Address - Street 1:108 PLANKWOOD CT
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-2920
Practice Address - Country:US
Practice Address - Phone:540-869-7919
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist