Basic Information
Provider Information
NPI: 1801856968
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: MICHAEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3515 MASSILLON RD
Address2: STE 300
City: UNIONTOWN
State: OH
PostalCode: 446857854
CountryCode: US
TelephoneNumber: 3308999350
FaxNumber: 3306341329
Practice Location
Address1: 3043 SANITARIUM RD
Address2: SUITE 1
City: AKRON
State: OH
PostalCode: 443124600
CountryCode: US
TelephoneNumber: 3306284044
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/24/2006
LastUpdateDate: 09/12/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X35-04-9940HOHY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
72975001OHBUCKEYE COMMUNITY HEALTHOTHER
00000013218001OHANTHEMOTHER
05801OHSUMMA CAREOTHER
059001605OH MEDICAID
01002251101OHRAILROAD MEDICAREOTHER
04757901OHSELECT CAREOTHER
341458069L01OHAULTCAREOTHER
04-0301901OHUNITED HEALTHCAREOTHER


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