Healthcare Provider Details

I. General information

NPI: 1053391615
Provider Name (Legal Business Name): LISA H HILL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA HILL MD

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 02/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43480 YUKON DRIVE STE. 206
ASHBURN VA
20147-7915
US

IV. Provider business mailing address

43480 YUKON DRIVE STE. 206
ASHBURN VA
20147-7915
US

V. Phone/Fax

Practice location:
  • Phone: 703-723-3201
  • Fax: 703-729-2736
Mailing address:
  • Phone: 703-723-3201
  • Fax: 703-729-2736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101224616
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: