Provider Demographics
NPI:1780660639
Name:HILL, MICHAEL ANDRE' (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANDRE'
Last Name:HILL
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 1:506 E CHEVES ST STE 202
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2616
Mailing Address - Country:US
Mailing Address - Phone:843-841-3846
Mailing Address - Fax:803-536-0998
Practice Address - Street 1:705 N 8TH AVE STE 2B
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-2549
Practice Address - Country:US
Practice Address - Phone:843-841-3846
Practice Address - Fax:843-841-3848
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21888202K00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC57680010-012OtherBCBS
SC20003459OtherFIRST CHOICE
SC9645030OtherGHI
SCT59674Medicaid
SCA6765OtherMEDCOST
SC9645030OtherGHI
SC57680010-012OtherBCBS
SCT59674Medicaid