Provider Demographics
NPI:1871662155
Name:HAMRICK, ROBERT AUGUSTUS II (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:AUGUSTUS
Last Name:HAMRICK
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 QUARRIER STREET
Mailing Address - Street 2:SUITE 313
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-2313
Mailing Address - Country:US
Mailing Address - Phone:304-343-1143
Mailing Address - Fax:
Practice Address - Street 1:1021 QUARRIER STREET
Practice Address - Street 2:SUITE 313
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-2313
Practice Address - Country:US
Practice Address - Phone:304-343-1143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV29611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0133297000Medicaid