Provider Demographics
NPI:1801846530
Name:HAMELIN, SCOTT G (OT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:G
Last Name:HAMELIN
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:WESTERNPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21562-1130
Mailing Address - Country:US
Mailing Address - Phone:240-362-1009
Mailing Address - Fax:
Practice Address - Street 1:RR 5 BOX 521
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-9016
Practice Address - Country:US
Practice Address - Phone:304-726-4212
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1028171W00000X
MD4890171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor