Basic Information
| Provider Information | |||||||||
| NPI: | 1912160359 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILLIARD | ||||||||
| FirstName: | ALLYSON | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 724 RIVER MIST DR | ||||||||
| Address2: | |||||||||
| City: | OXON HILL | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207453475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408478487 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8008 WESTPARK DR | ||||||||
| Address2: | |||||||||
| City: | MC LEAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221023109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032876400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2008 | ||||||||
| LastUpdateDate: | 10/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | C1-0025339 | DE | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 0101248851 | VA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | D79102 | MD | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.