Provider Demographics
NPI:1437372273
Name:HAMWAY, BRIAN JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOHN
Last Name:HAMWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BRIAN
Other - Middle Name:JOHN
Other - Last Name:HAMOUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:36 GRATTAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-4326
Mailing Address - Country:US
Mailing Address - Phone:415-854-1575
Mailing Address - Fax:877-992-3841
Practice Address - Street 1:36 GRATTAN ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-4326
Practice Address - Country:US
Practice Address - Phone:415-854-1575
Practice Address - Fax:877-992-3841
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG88412207R00000X
NY203202207R00000X
NJ25MA07710200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG34500Medicare UPIN