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General NPI Number Information
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NPI Number | 1801208749
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Entity Type | Individual
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Provider Name | DOUGLAS HIDLAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 500 MARTHA JEFFERSON DR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-4668
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Country | US
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Telephone | 434-654-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 3048 ENTERPRISE DR
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City | STATE COLLEGE
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State | PA
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Zip | 16801-2755
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Country | US
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Telephone | 434-654-7114
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD60941274
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | LP03119
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 60941274
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 0101269235
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License Number State | VA
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