Healthcare Provider Details

I. General information

NPI: 1134193295
Provider Name (Legal Business Name): MICHELLE R STUART HILGENFELD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 04/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3243 E MURDOCK ST SUITE #500
WICHITA KS
67208-3052
US

IV. Provider business mailing address

3243 E MURDOCK ST SUITE #201
WICHITA KS
67208-3052
US

V. Phone/Fax

Practice location:
  • Phone: 816-234-3000
  • Fax:
Mailing address:
  • Phone: 806-234-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-27789
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number04-27789
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: