Provider Demographics
NPI:1689112633
Name:HILL, PETER JOSEPH (MSN, AGPC-NP)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:JOSEPH
Last Name:HILL
Suffix:
Gender:M
Credentials:MSN, AGPC-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MARSHLAND RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2305
Mailing Address - Country:US
Mailing Address - Phone:843-842-6357
Mailing Address - Fax:843-842-6352
Practice Address - Street 1:2 MARSHLAND RD
Practice Address - Street 2:SUITE 5
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2305
Practice Address - Country:US
Practice Address - Phone:843-842-6357
Practice Address - Fax:843-842-6352
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20728363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG276558464Medicare UPIN