Provider Demographics
NPI:1215360607
Name:PATRICK E HAMILTON MD INC
Entity Type:Organization
Organization Name:PATRICK E HAMILTON MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-872-9595
Mailing Address - Street 1:PO BOX 1879
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-6879
Mailing Address - Country:US
Mailing Address - Phone:808-872-9595
Mailing Address - Fax:808-575-5224
Practice Address - Street 1:24 N CHURCH ST STE 308
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1608
Practice Address - Country:US
Practice Address - Phone:808-872-9595
Practice Address - Fax:808-575-5224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-5612261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
C97421Medicare UPIN