Provider Demographics
NPI:1679567127
Name:MILLER, KEVIN E (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:E
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3232 E MURDOCK ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-3003
Mailing Address - Country:US
Mailing Address - Phone:316-219-6777
Mailing Address - Fax:316-239-2828
Practice Address - Street 1:3232 E MURDOCK ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3003
Practice Address - Country:US
Practice Address - Phone:316-219-6777
Practice Address - Fax:316-239-2828
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87808207VG0400X
KS04-22358207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200540350AMedicaid
KS200540350AMedicaid
E60382Medicare UPIN
KSKA1129001Medicare PIN