Provider Demographics
NPI:1891868113
Name:HILLER, CARMEN ROCIO (MD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:ROCIO
Last Name:HILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CARMEN
Other - Middle Name:
Other - Last Name:HILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1321 GENERALS HWY STE 303
Mailing Address - Street 2:
Mailing Address - City:CROWNSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21032-2060
Mailing Address - Country:US
Mailing Address - Phone:410-858-1112
Mailing Address - Fax:410-770-4307
Practice Address - Street 1:1321 GENERALS HWY STE 303
Practice Address - Street 2:
Practice Address - City:CROWNSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21032-2060
Practice Address - Country:US
Practice Address - Phone:410-858-1112
Practice Address - Fax:410-770-4307
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0071757207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD335001100Medicaid
MD8446236OtherAETNA HMO
MDP19946OtherCAREFIRST BCBS POS
MD0119OtherCAREFIRST BCBS BLUECHOICE
MD252879OtherEHP/PRIORITY PARTNERS
MD4294799OtherAETNA PPO
MD97605201OtherCAREFIRST BCBS OF MARYLAND
MD97605201OtherCAREFIRST BCBS OF MARYLAND