Most Relevant Information
Provider Data
| NPI Number: | 1003544685 |
| Provider Name: | EDWIN RAYMOND MILLER |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 4704298100 |
Most Important Dates
| Enumeration Date: | 08/11/2022 |
| Last Updated: | 08/11/2022 |
Provider Practice Location
4646 JOHN R ST
DETROIT
MI
482011916
Practice Location Phone/Fax
| Phone: | 3135761000 |
| Fax: |
Provider Mailing Location
4646 JOHN R ST
DETROIT
MI
482011916
Provider Mailing Phone/Fax
| Phone: | 3135761000 |
| Fax: |