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General NPI Number Information
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NPI Number | 1558445379
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Entity Type | Individual
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Provider Name | TERESA LEAH HILLIARD DPM
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 10/30/2018
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Provider Practice Location Address
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Address Line | 5632 ANNAPOLIS RD STE 12
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City | BLADENSBURG
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State | MD
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Zip | 20710-2213
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Country | US
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Telephone | 301-390-4440
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Fax | 202-726-0656
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Provider Business Mailing Address
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Address Line | 615 QUACKENBOS ST NW
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City | WASHINGTON
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State | DC
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Zip | 20011-1229
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Country | US
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Telephone | 301-390-4440
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Fax | 202-726-0656
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 103000906
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 01129
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO517
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License Number State | DC
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