Provider Demographics
NPI:1790770196
Name:HILGER, PETER A (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:A
Last Name:HILGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7801 EAST BUSH LAKE ROAD
Mailing Address - Street 2:KALEIDOSCOPE
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3113
Mailing Address - Country:US
Mailing Address - Phone:952-831-5773
Mailing Address - Fax:952-831-7224
Practice Address - Street 1:7801 E BUSH LAKE RD
Practice Address - Street 2:SUITE 320
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55439-3120
Practice Address - Country:US
Practice Address - Phone:952-831-5773
Practice Address - Fax:952-831-7224
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN023875207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN040000272OtherPTAN #
MN040000272OtherPTAN #
040000272Medicare ID - Type Unspecified