Basic Information
| Provider Information | |||||||||
| NPI: | 1467612192 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BILHARTZ | ||||||||
| FirstName: | JACOB | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3621 S STATE ST | ||||||||
| Address2: | 700 KMS PLACE | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349362047 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 EAST MEDICAL CENTER DRIVE | ||||||||
| Address2: | 8TH FLOOR CS MOTT CHILDRENS HOSPITAL | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481094259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349364185 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2008 | ||||||||
| LastUpdateDate: | 07/09/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0206X | 4301091940 | MI | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology | 208000000X | 4301091940 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080T0004X | 4301091940 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Transplant Hepatology |
No ID Information.