Provider Demographics
NPI:1821056912
Name:HILLEMANN, STEFFEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEFFEN
Middle Name:
Last Name:HILLEMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7204
Mailing Address - Country:US
Mailing Address - Phone:802-862-6312
Mailing Address - Fax:802-658-3984
Practice Address - Street 1:364 DORSET ST
Practice Address - Street 2:SUITE 1
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6270
Practice Address - Country:US
Practice Address - Phone:802-862-6312
Practice Address - Fax:802-658-3984
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2011-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0009918174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009847Medicaid
VTP00057516OtherRR MEDICARE
NY02421598Medicaid
VT1009847Medicaid
VTH91595Medicare UPIN