Healthcare Provider Details

I. General information

NPI: 1518283464
Provider Name (Legal Business Name): DOUGLAS ALEXANDER HILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2010
Last Update Date: 07/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7911 WESTPARK DR APT 2515
MC LEAN VA
22102-4214
US

IV. Provider business mailing address

7911 WESTPARK DR APT 2515
MC LEAN VA
22102-4214
US

V. Phone/Fax

Practice location:
  • Phone: 509-951-0436
  • Fax:
Mailing address:
  • Phone: 509-951-0436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101260356
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: