Provider Demographics
NPI:1255319166
Name:HAMILTON, STEPHEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:C
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:116 DEFENSE HWY
Mailing Address - Street 2:STE 400
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7027
Mailing Address - Country:US
Mailing Address - Phone:410-897-9841
Mailing Address - Fax:410-897-9852
Practice Address - Street 1:116 DEFENSE HWY
Practice Address - Street 2:STE 400
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7027
Practice Address - Country:US
Practice Address - Phone:410-897-9841
Practice Address - Fax:410-897-9852
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD41698207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM32045OtherCDS LICENSE
D91480Medicare UPIN
646L226DMedicare ID - Type Unspecified