Healthcare Provider Details

I. General information

NPI: 1215718432
Provider Name (Legal Business Name): HILTON MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 E 9 MILE RD STE 3
FERNDALE MI
48220-1988
US

IV. Provider business mailing address

PO BOX 2121
SOUTHFIELD MI
48037-2121
US

V. Phone/Fax

Practice location:
  • Phone: 248-629-6242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM GONTE
Title or Position: OWNER
Credential: MD
Phone: 248-701-5222