Healthcare Provider Details

I. General information

NPI: 1396772679
Provider Name (Legal Business Name): SUSAN ALICIA HILBURN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 01/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LAHEY HOSPITAL & MEDICAL CTR 41 MALL ROAD
BURLINGTON MA
01805-0001
US

IV. Provider business mailing address

LAHEY HOSPITAL & MEDICAL CTR 41 MALL ROAD
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-3839
  • Fax: 781-744-1597
Mailing address:
  • Phone: 781-744-3839
  • Fax: 781-744-1597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number246012
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: