Individual
HAYDEN MICHAEL MCILWAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-3111
Mailing address
950 N MERIDIAN ST, INDIANAPOLIS, IN 46204-1077
(765) 747-3111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004240A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103779397
ANTHEM PTAN
IN
05
—
201033600D
—
IN
05
—
300085033
—
IN
Enumeration date
09/19/2023
Last updated
02/13/2025
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