Provider Demographics
NPI:1407871122
Name:HILL, KEVIN P (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:P
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:BETH ISRAEL DEACONESS MEDICAL CENTER
Mailing Address - Street 2:330 BROOKLINE AVE, GRYZMISH 133
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-667-1597
Mailing Address - Fax:617-667-1515
Practice Address - Street 1:BETH ISRAEL DEACONESS MEDICAL CENTER
Practice Address - Street 2:330 BROOKLINE AVE, GRYZMISH 133
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-667-1597
Practice Address - Fax:617-667-1515
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0434342084P0800X
MA2164282084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTPENDINGMedicare UPIN