Healthcare Provider Details

I. General information

NPI: 1033323639
Provider Name (Legal Business Name): STEPHEN L. HILEMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 HOSPITAL PLACE CENTRAL PENINSULA GENERAL HOSPITAL
SOLDOTNA AK
99669
US

IV. Provider business mailing address

PO BOX 572
WAVERLY PA
18471-0572
US

V. Phone/Fax

Practice location:
  • Phone: 907-714-4444
  • Fax: 907-714-4699
Mailing address:
  • Phone: 570-689-1669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License NumberAK 2848
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: