Provider Demographics
NPI:1902841208
Name:HILLSDALE MEDICAL ASSOCIATES, PLC
Entity Type:Organization
Organization Name:HILLSDALE MEDICAL ASSOCIATES, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCCANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-439-0200
Mailing Address - Street 1:1456 HUDSON RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-8314
Mailing Address - Country:US
Mailing Address - Phone:517-439-0200
Mailing Address - Fax:517-439-1050
Practice Address - Street 1:1456 HUDSON RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-8314
Practice Address - Country:US
Practice Address - Phone:517-439-0200
Practice Address - Fax:517-439-1050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4259357Medicaid
MI4259357Medicaid