Provider Demographics
NPI:1285745166
Name:HILL, BRUCE SHAWN (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:SHAWN
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 SEATON ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2625
Mailing Address - Country:US
Mailing Address - Phone:202-709-8482
Mailing Address - Fax:
Practice Address - Street 1:1330 NEW HAMPSHIRE AVE NW
Practice Address - Street 2:SUITE B-5
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6350
Practice Address - Country:US
Practice Address - Phone:202-709-8482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000-01164207RR0500X
GA0709512084P0800X
DCMD0424942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891268XMedicaid
NC891268XMedicaid
2280925CMedicare PIN