Provider Demographics
NPI:1467778738
Name:HILL, SAMAREH GHORBANI (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SAMAREH
Middle Name:GHORBANI
Last Name:HILL
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:SAMAREH
Other - Middle Name:
Other - Last Name:GHORBANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 603949
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3949
Mailing Address - Country:US
Mailing Address - Phone:919-350-0351
Mailing Address - Fax:919-350-7687
Practice Address - Street 1:23 SUNNYBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1855
Practice Address - Country:US
Practice Address - Phone:919-235-6439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0010915208000000X
NC2016-012922080B0002X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080B0002XAllopathic & Osteopathic PhysiciansPediatricsObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1467778738Medicaid