Provider Demographics
| NPI: | 1629006994 |
|---|---|
| Name: | HAMILTON-BRANDON, LUREDEAN GALE (MD) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | LUREDEAN |
| Middle Name: | GALE |
| Last Name: | HAMILTON-BRANDON |
| Suffix: | |
| Gender: | F |
| 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: | 2365 SPRINGS RD NE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HICKORY |
| Mailing Address - State: | NC |
| Mailing Address - Zip Code: | 28601-3067 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 828-256-2112 |
| Mailing Address - Fax: | 828-256-2393 |
| Practice Address - Street 1: | 2365 SPRINGS RD NE |
| Practice Address - Street 2: | |
| Practice Address - City: | HICKORY |
| Practice Address - State: | NC |
| Practice Address - Zip Code: | 28601-3067 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 828-256-2112 |
| Practice Address - Fax: | 828-256-2393 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2006-06-28 |
| Last Update Date: | 2021-04-29 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| NC | 96-00185 | 207Q00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NC | 135PH | Other | BCBS |
| NC | 89135PH | Medicaid | |
| NC | 2240903G | Medicare Oscar/Certification | |
| NC | 89135PH | Medicaid | |
| NC | 2240903H | Medicare Oscar/Certification | |
| NC | G55041 | Medicare UPIN |