Provider Demographics
NPI:1124537410
Name:HAMDY MEDICAL CENTER, PC
Entity Type:Organization
Organization Name:HAMDY MEDICAL CENTER, PC
Other - Org Name:HAMDY MEDICAL CENTER PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREEM
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-634-5003
Mailing Address - Street 1:110 COMMONWEALTH BLVD W
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-1913
Mailing Address - Country:US
Mailing Address - Phone:276-226-1210
Mailing Address - Fax:276-634-5017
Practice Address - Street 1:110 W COMMONWEALTH BLVD
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112
Practice Address - Country:US
Practice Address - Phone:276-634-5003
Practice Address - Fax:276-634-5017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208600000X, 363LF0000X, 363LP2300X
VA010241736261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10224OtherMEDICARE
VA1205852803Medicaid