Provider Demographics
NPI:1710957790
Name:HILDWEIN, ANTOINETTE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTOINETTE
Middle Name:MARIE
Last Name:HILDWEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1848
Mailing Address - Country:US
Mailing Address - Phone:231-672-7000
Mailing Address - Fax:231-728-5041
Practice Address - Street 1:3570 HENRY ST STE 120
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-4576
Practice Address - Country:US
Practice Address - Phone:213-672-7000
Practice Address - Fax:231-728-5041
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI231858Medicare Oscar/Certification
MIG59235Medicare UPIN