Provider Demographics
NPI:1881843027
Name:ALHILLI, MARIAM (MD)
Entity Type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:ALHILLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVENUE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195
Mailing Address - Country:US
Mailing Address - Phone:216-445-0747
Mailing Address - Fax:216-444-8551
Practice Address - Street 1:9500 EUCLID AVENUE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195
Practice Address - Country:US
Practice Address - Phone:216-445-0747
Practice Address - Fax:216-444-8551
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN52917207V00000X, 207VX0201X
390200000X
OH351259523207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1881843027Medicaid
MNP00940107OtherRAILROAD MEDICARE