Healthcare Provider Details

I. General information

NPI: 1124116918
Provider Name (Legal Business Name): STEVEN W. HAMRICK, DMD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 FALLS OF NEUSE ROAD SUITE 100
RALEIGH NC
27615
US

IV. Provider business mailing address

7501 FALLS OF NEUSE ROAD SUITE 100
RALEIGH NC
27615
US

V. Phone/Fax

Practice location:
  • Phone: 919-846-2480
  • Fax: 919-846-2482
Mailing address:
  • Phone: 919-846-2480
  • Fax: 919-846-2482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number5218
License Number StateNC

VIII. Authorized Official

Name: CHERYL A MADSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 919-846-2480