Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 430139845 | MI |
NPI | 1134145576 |
---|---|
Provider Name | Dr. Robert G Hylland |
First Address | Grand Rapids, MI 49546-7062 |
Second Address | Norton Shores, MI 49444 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 17/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A74769 | (02) | MI |