Provider Demographics
NPI:1447299011
Name:MILLER, ELIZABETH A (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:PO BOX 102635
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2635
Mailing Address - Country:US
Mailing Address - Phone:912-354-4800
Mailing Address - Fax:912-629-5821
Practice Address - Street 1:4720 WATERS AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6292
Practice Address - Country:US
Practice Address - Phone:912-354-4800
Practice Address - Fax:912-629-5821
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA029351207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000337972FMedicaid
GA10053812OtherAMERIGROUP
GA000337972DOtherMEDICAID - SAVANNAH
GA000337972EMedicaid
GA1447299011OtherMEDICARE RAILROAD
GA349805OtherWELLCARE
SCGPA977OtherMEDICAID GRP. SAV
GA52415798-001OtherBCBS
GA511G701032OtherMEDICARE GROUP
SCG29351Medicaid
C58663Medicare UPIN
GA6150410004Medicare NSC
GA0412940001Medicare NSC
SCGPA977OtherMEDICAID GRP. SAV
GA0412940004Medicare NSC
GA511G701032OtherMEDICARE GROUP
GA000337972FMedicaid
GA0412940005Medicare NSC
GA6150410005Medicare NSC
GA511I180077Medicare PIN