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General NPI Number Information
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NPI Number | 1477173862
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Entity Type | Individual
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Provider Name | MONTE HAMLET
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Gender | Male
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Dates
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Enumeration Date | 04/26/2020
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Last Update Date | 04/26/2020
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Provider Practice Location Address
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Address Line | 751 FAIRBURN RD SW APT 4303
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City | ATLANTA
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State | GA
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Zip | 30331-8557
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Country | US
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Telephone | 872-713-4517
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Fax |
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Provider Business Mailing Address
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Address Line | 751 FAIRBURN RD SW APT 4303
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City | ATLANTA
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State | GA
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Zip | 30331-8557
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Country | US
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Telephone | 872-713-4517
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 20027437
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License Number State | GA
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