Provider Demographics
NPI:1639236177
Name:HAMILTON, ANNETTE C (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:C
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:106 NORTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-6008
Mailing Address - Country:US
Mailing Address - Phone:770-888-6697
Mailing Address - Fax:770-888-6698
Practice Address - Street 1:407 E MAPLE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2656
Practice Address - Country:US
Practice Address - Phone:770-888-6697
Practice Address - Fax:770-888-6698
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054743207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG22681Medicare UPIN
GAGRP6994Medicare ID - Type Unspecified