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General NPI Number Information
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NPI Number | 1407022528
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Entity Type | Individual
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Provider Name | ERVIN EUGENE HAMILTON L.L.P.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 2775 W DICKMAN RD
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City | SPRINGFIELD
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State | MI
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Zip | 49037-4895
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Country | US
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Telephone | 269-883-6560
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Fax | 269-883-6891
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Provider Business Mailing Address
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Address Line | 49081 YE OLDE WOODS
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City | MATTAWAN
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State | MI
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Zip | 49071-9702
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Country | US
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Telephone | 269-250-0247
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301013743
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License Number State | MI
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