Provider Demographics
NPI:1053391615
Name:HILL, LISA H (MD)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:H
Last Name:HILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:43480 YUKON DRIVE
Mailing Address - Street 2:STE. 206
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7915
Mailing Address - Country:US
Mailing Address - Phone:703-723-3201
Mailing Address - Fax:703-729-2736
Practice Address - Street 1:43480 YUKON DRIVE
Practice Address - Street 2:STE. 206
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-7915
Practice Address - Country:US
Practice Address - Phone:703-723-3201
Practice Address - Fax:703-729-2736
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101224616208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006720145Medicaid