Healthcare Provider Details

I. General information

NPI: 1700049632
Provider Name (Legal Business Name): ROBERT HILLARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 GREEN VALLEY RD STE 104
GREENSBORO NC
27408-7038
US

IV. Provider business mailing address

706 GREEN VALLEY RD STE 104
GREENSBORO NC
27408-7038
US

V. Phone/Fax

Practice location:
  • Phone: 336-387-2500
  • Fax:
Mailing address:
  • Phone: 336-387-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number2012-01142
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: