Provider Demographics
NPI:1538123195
Name:HAMILTON OBSTETRICS & GYNECOLOGY,P.C.
Entity Type:Organization
Organization Name:HAMILTON OBSTETRICS & GYNECOLOGY,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:C.
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RIEDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-432-4665
Mailing Address - Street 1:1941 W HAMILTON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-6470
Mailing Address - Country:US
Mailing Address - Phone:610-432-4665
Mailing Address - Fax:610-432-8512
Practice Address - Street 1:1941 W HAMILTON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6470
Practice Address - Country:US
Practice Address - Phone:610-432-4665
Practice Address - Fax:610-432-8512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009291L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001755843 00006Medicaid
PA001831417 0002OtherMEDICAID GROUP
PA026537Medicare PIN
PA001831417 0002OtherMEDICAID GROUP