Provider Demographics
NPI:1871592824
Name:MILLER, STEWART CLAY (MD)
Entity type:Individual
Prefix:
First Name:STEWART
Middle Name:CLAY
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7045 SAINT ANDREWS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-1177
Mailing Address - Country:US
Mailing Address - Phone:803-781-7950
Mailing Address - Fax:803-781-0167
Practice Address - Street 1:7045 SAINT ANDREWS RD
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-1177
Practice Address - Country:US
Practice Address - Phone:803-781-7950
Practice Address - Fax:803-781-0167
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC14680207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC148600Medicaid
SC148600Medicaid