Provider Demographics
NPI:1861573131
Name:HILL, RUSSELL R (MD)
Entity type:Individual
Prefix:
First Name:RUSSELL
Middle Name:R
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11804 LISBOROUGH ROAD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720
Mailing Address - Country:US
Mailing Address - Phone:301-262-4181
Mailing Address - Fax:301-262-4181
Practice Address - Street 1:11804 LISBOROUGH ROAD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720
Practice Address - Country:US
Practice Address - Phone:301-262-4181
Practice Address - Fax:301-262-4181
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD12039207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D66461Medicare UPIN