| Natasha Miller, MD | |
|
315 E Elm, Ste 100, Caldwell, ID 83605-4858 | |
| (208) 459-7415 | |
| (208) 453-3307 |
| Full Name | Natasha Miller |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 315 E Elm, Caldwell, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144299678 | NPI | - | NPPES |
| 712598 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 30301 (Arizona) | Secondary |
| 208000000X | Pediatrics | M-10367 (Idaho) | Primary |
| Entity Name | St Lukes Clinic-treasure Valley Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
| Mailing Address | Practice Location Address |
|---|---|
| Natasha Miller, MD 3340 E Goldstone Way, Meridian, ID 83642-1026 Ph: (208) 367-5171 | Natasha Miller, MD 315 E Elm, Ste 100, Caldwell, ID 83605-4858 Ph: (208) 459-7415 |
Jee Hur, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 315 E Elm Street, Ste 100, Caldwell, ID 83605 Phone: 208-459-7415 Fax: 208-453-3307 | |
Amanda Lee, Pediatrics Medicare: Medicare Enrolled Practice Location: 1620 S Kimball Ave, Caldwell, ID 83605 Phone: 208-505-2950 | |
Merle L. Keller Iii, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 315 E. Elm Ste 100, Caldwell, ID 83605 Phone: 208-302-7100 Fax: 208-302-7155 | |
Matthew S Brown, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 712 Aviation Way, Caldwell, ID 83605 Phone: 208-302-7100 Fax: 208-302-7189 | |
Timothy Curtis Borup, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 712 Aviation Way, Caldwell, ID 83605 Phone: 208-302-7100 Fax: 208-302-7189 | |
Kaysea Lee Studioso-hatch, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 712 Aviation Way, Caldwell, ID 83605 Phone: 208-302-7100 Fax: 208-302-7189 |