Healthcare Provider Details

I. General information

NPI: 1891868113
Provider Name (Legal Business Name): CARMEN ROCIO HILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARMEN HILLER MD

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 GENERALS HWY STE 303
CROWNSVILLE MD
21032-2060
US

IV. Provider business mailing address

1321 GENERALS HWY STE 303
CROWNSVILLE MD
21032-2060
US

V. Phone/Fax

Practice location:
  • Phone: 410-858-1112
  • Fax: 410-770-4307
Mailing address:
  • Phone: 410-858-1112
  • Fax: 410-770-4307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0071757
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: