Individual
PETER J HILLSAMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2320 CONCORD RD STE A, LAFAYETTE, IN 47909-2710
(765) 477-7436
(765) 477-1245
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01038246A
IN
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
01038246A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100232740
—
IN
Enumeration date
11/06/2006
Last updated
01/02/2025
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