Doctor Name: | BRIAN STEPHEN HILLIARD |
NPI Number: | 1659715613 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 2500 Como Avenue St. Paul, MN - 551081460 |
Business Phone Number: | 9528538800 |
Business Fax Number: | 6516416205 |
Mailing Address: | Po Box 1309 8170 33rd Ave S, Mail Stop 21110q MINNEAPOLIS |
State: | MN |
Postal Code: | 554254516 |
Phone Number: | 9528538800 |
Fax Number: | 6516416205 |
NPI Enumeration Date: | 04/22/2013 |
NPI Last Update Date: | 01/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |