Healthcare Provider Details

I. General information

NPI: 1215376124
Provider Name (Legal Business Name): JENNIFER LAUREN HAMILTON M.S.P.A.S, P.A.-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER LAUREN HAMILTON M.S.P.A.S, P.A.-C.

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 W BALTIMORE ST MSTF, SUITE 8-00
BALTIMORE MD
21201
US

IV. Provider business mailing address

685 W BALTIMORE ST
BALTIMORE MD
21201-1509
US

V. Phone/Fax

Practice location:
  • Phone: 410-706-3387
  • Fax: 410-706-4330
Mailing address:
  • Phone: 410-706-3387
  • Fax: 410-706-4330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberC05068
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA5163
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: