Provider Demographics
NPI:1295793727
Name:MILLER, CARLTON EDWIN
Entity type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:EDWIN
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 1:110 DUNLOP VLG
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1764
Mailing Address - Country:US
Mailing Address - Phone:804-526-6062
Mailing Address - Fax:804-526-9094
Practice Address - Street 1:110 DUNLOP VLG
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1764
Practice Address - Country:US
Practice Address - Phone:804-526-6062
Practice Address - Fax:804-526-9094
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040561207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006022499Medicaid
VA101628OtherCIGNA
VA101628OtherCIGNA