Provider Demographics
NPI:1053375675
Name:MILLER, ALLAN MARQUESS (MD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:MARQUESS
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S ORANGE GROVE BLVD APT 100
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-1756
Mailing Address - Country:US
Mailing Address - Phone:303-819-9933
Mailing Address - Fax:
Practice Address - Street 1:2596 F RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1443
Practice Address - Country:US
Practice Address - Phone:970-254-3180
Practice Address - Fax:970-254-3198
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42434174400000X
CODR.0042434207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC800397Medicare ID - Type UnspecifiedMEDICARE
COC25359Medicare UPIN