Russell Colton Miller, PA
Physician Assistant in Greer, SC. Individual provider (NPI-1).
NPI number1669095915
StatusActive
Last updated in NPPESJan 3, 2024
Details
- NPI
- 1669095915
- Entity type
- Individual (NPI-1)
- Name
- Russell Colton Miller
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 21, 2020
- Certification date
- Jan 3, 2024
- Last updated
- Jan 3, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 4772 | SC | Yes |
Practice location
2755 S Highway 14 Ste 1200lGreer, SC 29650-4902
Phone 864-849-9150 · Fax 864-849-9334
Mailing address
Po Box 743070Atlanta, GA 30374-3070
Phone 864-560-4304 · Fax 864-560-4413
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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