Provider Demographics
NPI:1700049632
Name:HILLARD, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:HILLARD
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 1:706 GREEN VALLEY RD
Mailing Address - Street 2:STE 104
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7038
Mailing Address - Country:US
Mailing Address - Phone:336-387-2500
Mailing Address - Fax:
Practice Address - Street 1:706 GREEN VALLEY RD
Practice Address - Street 2:STE 104
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7038
Practice Address - Country:US
Practice Address - Phone:336-387-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-01142207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5920880Medicaid
NCNC7660AMedicare PIN