Provider Demographics
NPI:1457532798
Name:HILL, TERRI LYNN (MD)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNN
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 1:4785 DORSEY HALL DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7728
Mailing Address - Country:US
Mailing Address - Phone:410-992-9600
Mailing Address - Fax:410-992-9641
Practice Address - Street 1:4785 DORSEY HALL DR
Practice Address - Street 2:SUITE 111
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7728
Practice Address - Country:US
Practice Address - Phone:410-992-9600
Practice Address - Fax:410-992-9641
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD42191208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD3485011300MDMedicaid
MDF07544OtherUPIN
MD3485011300MDMedicaid