MEDICARE: MARK S HAMILTON MD

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	207Q00000X	Family Medicine Physician	4301044657	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760471312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK S HAMILTON MD

Provider Business Mailing Address
First Line	:	43800 GARFIELD RD
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48038-1136
Country	:	US
Telephone Number	:	800-848-0202
Fax Number	:	586-226-6949

Provider Business Practice Location Address
First Line	:	4014 S RIVER RD
Second Line	:
City	:	EAST CHINA
State	:	MI
Zip	:	48054-2916
Country	:	US
Telephone Number	:	810-329-6677
Fax Number	:	810-329-5730

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

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	02/11/2011

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Directions to “ MARK S HAMILTON MD” Practice Location

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