MEDICARE: DR. MARY PAT HAMILTON M.D.

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	207P00000X	Emergency Medicine Physician	32199	TN
2	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	26401	WV
3	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	32199	TN
4	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	0101102768	VA

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	:	1861439002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY PAT HAMILTON M.D.

Provider Business Mailing Address
First Line	:	1953 SHEPHERDS STORE RD
Second Line	:
City	:	BEDFORD
State	:	VA
Zip	:	24523-5510
Country	:	US
Telephone Number	:	540-494-0505
Fax Number	:

Provider Business Practice Location Address
First Line	:	1953 SHEPHERDS STORE RD
Second Line	:
City	:	BEDFORD
State	:	VA
Zip	:	24523-5510
Country	:	US
Telephone Number	:	540-494-0505
Fax Number	:

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/25/2017

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