Provider Demographics
NPI:1578589370
Name:HAMILL, CHALMERS M (MD)
Entity Type:Individual
Prefix:
First Name:CHALMERS
Middle Name:M
Last Name:HAMILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 FRANKLIN ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1221
Mailing Address - Country:US
Mailing Address - Phone:203-709-6000
Mailing Address - Fax:
Practice Address - Street 1:56 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1221
Practice Address - Country:US
Practice Address - Phone:203-709-6000
Practice Address - Fax:203-709-3679
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT022056207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT293594OtherWELLCARE
CT4111885OtherAETNA
CTP3615781OtherOXFORD
CT001220565Medicaid
CT0712540OtherCONNECTICARE
CT01397604OtherCOVENTRY/FIRST HEALTH
CT977587OtherUSA
CTP00385040OtherRR MEDICARE
CT010022056CT05OtherANTHEM BCBS CT
CT010022056CT05OtherANTHEM BCBS CT
CTP3615781OtherOXFORD