Provider Demographics
NPI:1104818244
Name:HILL, MICHAEL A (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:309 COUNTY ROUTE 47
Mailing Address - Street 2:SUITE #4
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-5405
Mailing Address - Country:US
Mailing Address - Phone:518-891-1610
Mailing Address - Fax:518-891-5726
Practice Address - Street 1:309 COUNTY ROUTE 47
Practice Address - Street 2:SUITE #4
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-5405
Practice Address - Country:US
Practice Address - Phone:518-891-1610
Practice Address - Fax:518-891-5726
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2015-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY218628-1208G00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02148658Medicaid
H39182Medicare UPIN
NY02148658Medicaid