Provider Demographics
NPI:1003927153
Name:MUSKEGON RHEUMATOLOGY P.C.
Entity type:Organization
Organization Name:MUSKEGON RHEUMATOLOGY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:HYLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-722-2036
Mailing Address - Street 1:172 E FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-5541
Mailing Address - Country:US
Mailing Address - Phone:231-722-2036
Mailing Address - Fax:
Practice Address - Street 1:172 E FOREST AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5541
Practice Address - Country:US
Practice Address - Phone:231-722-2036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MP=========OtherCOMMERCIAL INSURANCE
MIA74769Medicare UPIN
MI0P02550Medicare ID - Type UnspecifiedAARON D HUNT PA-C
MI0P01960Medicare ID - Type UnspecifiedROBERT G HYLLAND M D