Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 023875 | MN |
NPI | 1790770196 |
---|---|
Provider Name | Peter A Hilger |
First Address | Bloomington, MN 55439-3113 |
Second Address | Minneapolis, MN 55439-3120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 03/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040000272 | PTAN # (01) | MN |
A95244 | (02) |