Provider Demographics
NPI:1144233537
Name:HILL, MICHAEL ELLIOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ELLIOTT
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73180 EL PASEO
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-4218
Mailing Address - Country:US
Mailing Address - Phone:760-346-3810
Mailing Address - Fax:760-346-3083
Practice Address - Street 1:73180 EL PASEO
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-4218
Practice Address - Country:US
Practice Address - Phone:760-346-3810
Practice Address - Fax:760-346-3083
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35136208200000X
CAG87752208200000X
FLME 69692208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8942414Medicaid
NC42414OtherBC/BS
NC2332183Medicare ID - Type Unspecified
NC8942414Medicaid