Provider Demographics
NPI:1942309943
Name:STEWART MILLER, REBECCA (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STEWART MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 TAYLOR RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3563
Mailing Address - Country:US
Mailing Address - Phone:334-281-1191
Mailing Address - Fax:334-281-1940
Practice Address - Street 1:470 TAYLOR RD
Practice Address - Street 2:SUITE 300
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3563
Practice Address - Country:US
Practice Address - Phone:334-281-1191
Practice Address - Fax:334-281-1191
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21193207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL97662OtherBCBS OF ALABAMA
AL640801795OtherTRICARE
AL009936820Medicaid
AL7410600OtherUNITED HEALTHCARE
ALG90052Medicare UPIN
AL102I162398Medicare PIN