Healthcare Provider Details

I. General information

NPI: 1619054046
Provider Name (Legal Business Name): PAULETTE CAMILLE HILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 S PRESIDENT ST APT 1335
BALTIMORE MD
21202-4497
US

IV. Provider business mailing address

7172 SPRINGHOUSE LN
BALTIMORE MD
21226-2200
US

V. Phone/Fax

Practice location:
  • Phone: 410-244-8384
  • Fax:
Mailing address:
  • Phone: 410-255-3626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberD18887
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: