Provider Demographics
NPI:1043368657
Name:FRED HILLWIG, PSY.D., P.A.
Entity Type:Organization
Organization Name:FRED HILLWIG, PSY.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:J
Authorized Official - Last Name:HILLWIG
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:410-628-1978
Mailing Address - Street 1:3313 PAPER MILL RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:PHOENIX
Mailing Address - State:MD
Mailing Address - Zip Code:21131-1465
Mailing Address - Country:US
Mailing Address - Phone:410-628-1978
Mailing Address - Fax:410-667-0915
Practice Address - Street 1:3313 PAPER MILL RD
Practice Address - Street 2:SUITE 7
Practice Address - City:PHOENIX
Practice Address - State:MD
Practice Address - Zip Code:21131-1465
Practice Address - Country:US
Practice Address - Phone:410-628-1978
Practice Address - Fax:410-667-0915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD 04188103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty