Provider Demographics
NPI:1013978790
Name:HILL, DARRYL A (MD)
Entity type:Individual
Prefix:
First Name:DARRYL
Middle Name:A
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 1:13635 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707
Mailing Address - Country:US
Mailing Address - Phone:301-497-0601
Mailing Address - Fax:301-497-0402
Practice Address - Street 1:13635 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707
Practice Address - Country:US
Practice Address - Phone:301-497-0601
Practice Address - Fax:301-497-0402
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0053235207R00000X
DC31761207R00000X
VA0101840502207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD214502200Medicaid
G74887Medicare UPIN
MD519GMedicare PIN
DC00B538L02Medicare PIN