Provider Demographics
NPI:1811942097
Name:HILLMAN, DONALD LOUIS (DO)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:LOUIS
Last Name:HILLMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 PATIENT CARE DR
Mailing Address - Street 2:STE A
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911
Mailing Address - Country:US
Mailing Address - Phone:517-374-7600
Mailing Address - Fax:855-495-5457
Practice Address - Street 1:839 S PUTNAM ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:MI
Practice Address - Zip Code:48895-1623
Practice Address - Country:US
Practice Address - Phone:517-655-3515
Practice Address - Fax:855-476-0189
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDH007694207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1811942097Medicaid
MI1811942097Medicaid
MI0F06016051Medicare PIN
MI0F06016OtherMEDICARE BILL PAY TO
MI4827614Medicaid
F10362Medicare UPIN
MI4892926Medicaid