Healthcare Provider Details

I. General information

NPI: 1336160423
Provider Name (Legal Business Name): MARY KAY HILLINGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR DHMC ALLERGY
LEBANON NH
03756-1000
US

IV. Provider business mailing address

1 MEDICAL CENTER DR DHMC ALLERGY
LEBANON NH
03756-1000
US

V. Phone/Fax

Practice location:
  • Phone: 603-653-9885
  • Fax: 603-650-0907
Mailing address:
  • Phone: 603-653-9885
  • Fax: 603-650-0907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number11945
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: