Healthcare Provider Details

I. General information

NPI: 1902858467
Provider Name (Legal Business Name): HUGH HILL III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 03/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 EASTERN AVE
BALTIMORE MD
21224-2735
US

IV. Provider business mailing address

PO BOX 64362
BALTIMORE MD
21264-4362
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-0350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD23540
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: