IndividualActive
Justin Miller, PA
NPI 1003055666 · Surgical Physician Assistant · Grand Rapids, MI
Provider details
- NPI number
- 1003055666
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- 0010-01677 (NC)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1111 Leffingwell Ave Ne
Grand Rapids, MI 49525-6406
Phone: (616) 459-7101
Approximate (ZIP-level) locationGet directions
Mailing address
1111 Leffingwell Ave Ne
Grand Rapids, MI 49525-6406
Registry dates
- Enumerated
- 2009-02-05
- Last updated
- 2014-05-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.