Provider Demographics
NPI:1245380047
Name:VERNON, HILARY JOYCE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:HILARY
Middle Name:JOYCE
Last Name:VERNON
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64316
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4316
Mailing Address - Country:US
Mailing Address - Phone:410-955-3071
Mailing Address - Fax:
Practice Address - Street 1:600 NORTH WOLFE STREET
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS, CMSC 2-124
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-3224
Practice Address - Country:US
Practice Address - Phone:410-614-4493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP20049208000000X
MDD68956208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD21264-4316Medicaid
MD228713Y64Medicare PIN