1083605927 NPI number — DR. PAMELA KAY HILTON MD

Table of content: DR. PAMELA KAY HILTON MD (NPI 1083605927)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083605927 NPI number — DR. PAMELA KAY HILTON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILTON
Provider First Name:
PAMELA
Provider Middle Name:
KAY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083605927
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19475 CAVENDISH CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH ROYALTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44133-6117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-237-9347
Provider Business Mailing Address Fax Number:
216-749-8273

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7575 NORTHCLIFF AVE
Provider Second Line Business Practice Location Address:
SUITE 307
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44144-3267
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-749-8277
Provider Business Practice Location Address Fax Number:
216-749-8273
Provider Enumeration Date:
10/31/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  35-05-3099-H , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 393428 . This is a "WELLCARE OF OH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 105348 . This is a "KAISER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000183812 . This is a "UNICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000183812 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: P53099 . This is a "SUMMACARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0808675 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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