Provider Demographics
NPI:1821525122
Name:LIKEN, HILLARY BLAIR (MD)
Entity Type:Individual
Prefix:DR
First Name:HILLARY
Middle Name:BLAIR
Last Name:LIKEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 EAST HOSPITAL DRIVE, SPC 4204
Mailing Address - Street 2:CW 11-712
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-4204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1540 EAST HOSPITAL DRIVE, SPC 4204
Practice Address - Street 2:CW 11-712
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-4204
Practice Address - Country:US
Practice Address - Phone:706-340-1716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-17
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC227761390200000X
NC2020-02636208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program