Provider Demographics
NPI:1831123025
Name:HILLS, CARVER A (MD)
Entity Type:Individual
Prefix:
First Name:CARVER
Middle Name:A
Last Name:HILLS
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 1:2501 REED ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-3900
Mailing Address - Country:US
Mailing Address - Phone:215-468-7220
Mailing Address - Fax:215-468-7221
Practice Address - Street 1:235 N BROAD ST STE 200
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1531
Practice Address - Country:US
Practice Address - Phone:215-468-7220
Practice Address - Fax:215-468-7221
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056560L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015904580008Medicaid
PA0015904580008Medicaid
PA0000877743Medicare ID - Type Unspecified