Provider Demographics
NPI:1629059233
Name:HAMILTON, SCOTT MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:MARTIN
Last Name:HAMILTON
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 1:1733 HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6638
Mailing Address - Country:US
Mailing Address - Phone:301-797-2525
Mailing Address - Fax:301-797-5519
Practice Address - Street 1:1733 HOWELL RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6638
Practice Address - Country:US
Practice Address - Phone:301-797-2525
Practice Address - Fax:301-797-5519
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044316207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0204094000Medicaid
MD1379791008OtherCIGNA
MD644291900Medicaid
MD2500611OtherUNITED HEALTHCARE
145744300OtherUS DEPT OF LABOR
MD52818002OtherBC/BS
PA540587OtherBC/BS
GA985048676AMedicaid
DCB3890004OtherBC/BS
MD060060903Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MD644291900Medicaid
MDF62683Medicare UPIN