Provider Demographics
NPI:1780770768
Name:HILL, CONITA L (PA)
Entity type:Individual
Prefix:
First Name:CONITA
Middle Name:L
Last Name:HILL
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1773 VILLAGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2475
Mailing Address - Country:US
Mailing Address - Phone:803-535-3600
Mailing Address - Fax:803-534-6300
Practice Address - Street 1:1773 VILLAGE PARK DR
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2475
Practice Address - Country:US
Practice Address - Phone:803-535-3600
Practice Address - Fax:803-534-6300
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2024-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC749363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC749OtherSTATE LICENSE