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General NPI Number Information
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NPI Number | 1720974033
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Entity Type | Individual
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Provider Name | EMMANUEL HAMELIN DO
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Gender | Male
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 320 E. HOSPITAL ROAD FORT EISENHOWER
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City | AUGUSTA
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State | GA
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Zip | 30905
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Country | US
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Telephone | 706-787-5102
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 POINTE GRAND DR # 3101
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City | AUGUSTA
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State | GA
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Zip | 30909-4864
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Country | US
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Telephone | 418-271-9324
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Fax | 418-271-9324
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 24414
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License Number State | GA
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