Provider Demographics
NPI:1225079791
Name:M ROBERT HILL MD
Entity Type:Organization
Organization Name:M ROBERT HILL MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:M
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-768-3220
Mailing Address - Street 1:6125 CLAYTON AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-3265
Mailing Address - Country:US
Mailing Address - Phone:314-768-3220
Mailing Address - Fax:314-768-5607
Practice Address - Street 1:6125 CLAYTON AVE
Practice Address - Street 2:STE 101
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-3265
Practice Address - Country:US
Practice Address - Phone:314-768-3220
Practice Address - Fax:314-768-5607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00005690032OtherAETNA PRIV PRACTICE
MO110003130OtherRR MCR PRIV PRACTICE
181103OtherBCBS PRIV PRACTICE
MO201050606Medicaid