Provider Demographics
NPI:1184683880
Name:HILL, MARY W (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:W
Last Name:HILL
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 1:989 RIBAUT RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5472
Mailing Address - Country:US
Mailing Address - Phone:843-522-5600
Mailing Address - Fax:843-522-5598
Practice Address - Street 1:989 RIBAUT RD
Practice Address - Street 2:SUITE 240
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5472
Practice Address - Country:US
Practice Address - Phone:843-522-5600
Practice Address - Fax:843-522-5598
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012330992084P0800X
NC2008-001452084P0800X
SC324752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC324759Medicaid
NC14737OtherBCBS
VA007118422Medicaid
WV2003595000Medicaid
VA245980OtherANTHEM
NC1184683880OtherMEDCOST
NC5908531Medicaid
WV2003595000Medicaid
NC14737OtherBCBS
SCH40981Medicare UPIN
NC5908531Medicaid
VA007118422Medicaid
NC2021884Medicare PIN