Provider Demographics
NPI:1447333158
Name:PATRICK-MILLER, TIMOTHY J (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:J
Last Name:PATRICK-MILLER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1040 SIERRA DRIVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7241
Mailing Address - Country:US
Mailing Address - Phone:317-528-4886
Mailing Address - Fax:317-859-8239
Practice Address - Street 1:221 US HIGHWAY 41
Practice Address - Street 2:SUITE 1
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1277
Practice Address - Country:US
Practice Address - Phone:219-864-3950
Practice Address - Fax:219-864-3952
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2015-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04624500208000000X
IN01072615A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics