Healthcare Provider Details

I. General information

NPI: 1821380643
Provider Name (Legal Business Name): PAUL DAVID HILES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2011
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 N MLK BLVD
NORTH LAS VEGAS NV
89032-3205
US

IV. Provider business mailing address

4040 N MLK BLVD
NORTH LAS VEGAS NV
89032-3205
US

V. Phone/Fax

Practice location:
  • Phone: 703-470-5685
  • Fax:
Mailing address:
  • Phone: 703-470-5685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number22136
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: