Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 4301084779 | MI |
NPI | 1073583126 |
---|---|
Provider Name | Neal D Hillman |
First Address | Grand Rapids, MI 49503-2560 |
Second Address | Grand Rapids, MI 49503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 18/03/2021 |