Provider Demographics
NPI:1174552590
Name:HILL, ANDREA (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4607 MACCORKLE AVE SW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1364
Mailing Address - Country:US
Mailing Address - Phone:304-768-7228
Mailing Address - Fax:304-768-7772
Practice Address - Street 1:4607 MACCORKLE AVE SW
Practice Address - Street 2:SUITE 201
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1364
Practice Address - Country:US
Practice Address - Phone:304-768-7228
Practice Address - Fax:304-768-7772
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV35224174400000X
WV23850207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV4287791Medicare PIN
KY000000229057OtherANTHEM PROVIDER NUMBER
H85977Medicare UPIN
KY07-00856OtherUNITED HEALTHCARE PROVIDE
KY64054372Medicaid