Provider Demographics
NPI:1568409522
Name:HILTS, MICHAEL JOHN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:HILTS
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 1:411 PARKWAY AVENUE
Mailing Address - Street 2:SUITE E1
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401
Mailing Address - Country:US
Mailing Address - Phone:336-895-1112
Mailing Address - Fax:336-895-1160
Practice Address - Street 1:411 PARKWAY AVENUE
Practice Address - Street 2:SUITE E1
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-895-1112
Practice Address - Fax:336-895-1160
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1828207Q00000X
NC9601205207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891218AMedicaid
NCP00221792OtherRAILROAD MEDICARE
NCP00221792OtherRAILROAD MEDICARE
NC2251242BMedicare PIN