Tiller, Michael
Tiller, Michael is an individual health care provider with primary practice located at 3551 Roger Brooke Dr , Fort Sam Houston TX 78234-4504. He recently has 4 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Trauma Surgery is his primary health care specialty. Tiller, Michael can be contacted via phone (202) 425-2103.Contact Information
Primary practice address
3551 Roger Brooke Dr
Fort Sam Houston TX 78234-4504
Phone: (202) 425-2103
Fax: (215) 243-4605
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Military Health Care Provider | 171000000X | 4301075583 | Michigan |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 4301075583 | Michigan |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD457338 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | MD457338 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | 4301075583 | Michigan |
Profile Details
| NPI number | 1356306658 |
|---|---|
| LBN Legal business name | Tiller, Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Apr 13th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356306658 | NPPES |
| District of Columbia | MEDICAID | 1356306658 |
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