Basic Information
Provider Information
NPI: 1306232715
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILSMAN
FirstName: MATTHEW
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2700 WAYNE MEMORIAL DR
Address2:  
City: GOLDSBORO
State: NC
PostalCode: 275349494
CountryCode: US
TelephoneNumber: 9197361110
FaxNumber: 9197347570
Practice Location
Address1: 2700 WAYNE MEMORIAL DR
Address2:  
City: GOLDSBORO
State: NC
PostalCode: 27534
CountryCode: US
TelephoneNumber: 9197361110
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/13/2015
LastUpdateDate: 03/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X210163NCN Student, Health CareStudent in an Organized Health Care Education/Training Program 
208M00000X2018-01406NCN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X2018-01406NCY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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