Healthcare Provider Details

I. General information

NPI: 1285932061
Provider Name (Legal Business Name): HILLEMANN & KIRWAN MDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 TIMBER LN
S BURLINGTON VT
05403-7204
US

IV. Provider business mailing address

50 TIMBER LN
S BURLINGTON VT
05403-7204
US

V. Phone/Fax

Practice location:
  • Phone: 802-862-6312
  • Fax: 802-658-3984
Mailing address:
  • Phone: 802-862-6312
  • Fax: 802-658-3984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: STEFFAN HILLEMANN
Title or Position: OWNER
Credential: MD
Phone: 802-862-6312