MEDICARE: MONIQUE HAMILTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor
2	171M00000X	Case Manager/Care Coordinator		OH

General Provider Information

NPI Number	:	1679461842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE HAMILTON

Provider Business Mailing Address
First Line	:	1246 IROQUOIS AVE
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-1547
Country	:	US
Telephone Number	:	216-832-5141
Fax Number	:

Provider Business Practice Location Address
First Line	:	1246 IROQUOIS AVE
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-1547
Country	:	US
Telephone Number	:	216-832-5141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2025
Last Update Date	:	08/09/2025

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Directions to “ MONIQUE HAMILTON ” Practice Location

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