MEDICARE: DR. MICHAEL CHARLES HAMSTEAD D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3772	SC

General Provider Information

NPI Number	:	1124437686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL CHARLES HAMSTEAD D.C.

Provider Business Mailing Address
First Line	:	19 DUXBURY DR
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-5794
Country	:	US
Telephone Number	:	304-281-2292
Fax Number	:

Provider Business Practice Location Address
First Line	:	419 SE MAIN ST
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-2673
Country	:	US
Telephone Number	:	304-281-2292
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2014
Last Update Date	:	08/10/2014

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