Provider Demographics
NPI:1235273913
Name:HILL, WARREN LESLIE JR (PD)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:LESLIE
Last Name:HILL
Suffix:JR
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8718 PINE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-2543
Mailing Address - Country:US
Mailing Address - Phone:410-672-5858
Mailing Address - Fax:
Practice Address - Street 1:703 GIDDINGS AVE
Practice Address - Street 2:SUITE L1
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1411
Practice Address - Country:US
Practice Address - Phone:410-263-7440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15729183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist