Provider Demographics
NPI:1912107269
Name:HILL, DEREK L (DO)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:L
Last Name:HILL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:P O BOX 71587
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-9991
Mailing Address - Country:US
Mailing Address - Phone:586-573-8100
Mailing Address - Fax:888-850-3877
Practice Address - Street 1:928 E 10 MILE RD STE 400
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-3041
Practice Address - Country:US
Practice Address - Phone:248-268-4296
Practice Address - Fax:888-850-3877
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2023-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS012967207XS0114X
MI5101015416207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIPENDINGOtherAETNA
MI1912107269Medicaid
MION FILEOtherBLUE CROSS OF MI
MI1912107269Medicaid