Individual
DEIDRE K HILLIARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1310 SOUTHERN AVE SE, WASHINGTON, DC 20032-4623
(202) 741-2302
(202) 741-2637
Mailing address
1310 SOUTHERN AVE SE, WASHINGTON, DC 20032-4623
(202) 741-2302
(202) 741-2637
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
207R0000X
KY
208M00000X
Hospitalist Physician
Primary
MD043436
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000640112
BC/BS
KY
01
—
3746248000
PASSPORT ADVANTAGE
KY
01
—
50026299
PASSPORT HEALTH PLAN
KY
05
—
7100089620
—
KY
01
—
P00829877
RAILROAD MEDICARE
KY
Enumeration date
03/08/2007
Last updated
11/08/2018
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