Dr. Shane Michael Miller, PharmD
Pharmacist in Macomb, IL. Individual provider (NPI-1).
NPI number1114201183
StatusActive
Last updated in NPPESOct 17, 2025
Details
- NPI
- 1114201183
- Entity type
- Individual (NPI-1)
- Name
- Dr. Shane Michael Miller
- Credential
- PharmD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 7, 2011
- Certification date
- Oct 17, 2025
- Last updated
- Oct 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 051.293200 | IL | Yes |
Practice location
533 E Grant StMacomb, IL 61455-3313
Phone 309-575-4679 · Fax 309-836-1910
Mailing address
1 Hickory GrvMacomb, IL 61455-1108
Phone 309-360-1202
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All 20 Pharmacist providers in Macomb · All 428 providers in Macomb
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