Provider Demographics
NPI:1659590974
Name:HAMILTON, DAVID W (NP MSN)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:W
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:NP MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 V ST STE 3500
Mailing Address - Street 2:GASTROENTEROLOGY DIVISION
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1460
Mailing Address - Country:US
Mailing Address - Phone:916-734-7224
Mailing Address - Fax:
Practice Address - Street 1:4150 V ST STE 3500
Practice Address - Street 2:GASTROENTEROLOGY DIVISION
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1460
Practice Address - Country:US
Practice Address - Phone:916-734-7224
Practice Address - Fax:916-734-7908
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF16236363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
116780OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
Q68766Medicare UPIN