Basic Information
| Provider Information | |||||||||
| NPI: | 1114280468 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5005 NORTH PIEDRAS STREET | ||||||||
| Address2: | WILLIAM BEAUMONT ARMY MEDICAL CENTER | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799205001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9157422521 | ||||||||
| FaxNumber: | 9157422653 | ||||||||
| Practice Location | |||||||||
| Address1: | 2817 REILLY ST | ||||||||
| Address2: | |||||||||
| City: | FORT BRAGG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283105001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9109076000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2012 | ||||||||
| LastUpdateDate: | 06/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 2020-02970 | NC | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.