Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 4284 | LA |
NPI | 1013047158 |
---|---|
Provider Name | Dr. Michael E Hiller |
First Address | Baton Rouge, LA 70816 |
Second Address | Baton Rouge, LA 70816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 06/06/2014 |