Michael R Dillard, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00024124 Issued in WA

Practice address

835 E Fairhaven Ave
Burlington, WA 98233-1916

Phone

(360) 755-0641

Fax

(360) 755-1405

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1376522367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 329",
            "address_2": "835 EAST FAIRHAVEN AVE",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982330329",
            "telephone_number": "360-755-0641",
            "fax_number": "360-755-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 E FAIRHAVEN AVE",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982331916",
            "telephone_number": "360-755-0641",
            "fax_number": "360-755-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00024124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018043",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda K. De Vries, LMP
• Laura Ellen Defreese, BS
• Alice Dellisanti, D.D.S.
• Dental Care Burlington Wa
• John Francis Dickey, CP60426031
• Stephanie R Dodd
• Julie Anna Doster Dodge, LMHC, ATR-P, MA
• Sara Dossen, RN
• Charvet Drucker, M.ED., BCBA
• Eagle Healthcare, Inc

• Family Medicine Physician in Burlington, WA
• Providers in Burlington, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.