Provider Demographics
NPI:1457523656
Name:HILAIRE, MAC-ELDER (MD)
Entity Type:Individual
Prefix:DR
First Name:MAC-ELDER
Middle Name:
Last Name:HILAIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MAC-ELDER
Other - Middle Name:
Other - Last Name:HILAIRE TOUSSAINT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 ABALONE LOOP
Mailing Address - Street 2:MESCALERO HOSPITAL
Mailing Address - City:MESCALERO
Mailing Address - State:NM
Mailing Address - Zip Code:88340
Mailing Address - Country:US
Mailing Address - Phone:575-464-4441
Mailing Address - Fax:575-464-4422
Practice Address - Street 1:1 ABALONE LOOP
Practice Address - Street 2:MESCALERO HOSPITAL
Practice Address - City:MESCALERO
Practice Address - State:NM
Practice Address - Zip Code:88340
Practice Address - Country:US
Practice Address - Phone:575-464-4441
Practice Address - Fax:575-464-4422
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16729207Q00000X, 207QA0000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine