Provider Demographics
NPI:1922741669
Name:HAMILTON, ROBERT MATTHEW (MDIV, DMIN)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MATTHEW
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:MDIV, DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 ANTLER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-3100
Mailing Address - Country:US
Mailing Address - Phone:910-338-8711
Mailing Address - Fax:
Practice Address - Street 1:1606 WELLINGTON AVE STE H
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7704
Practice Address - Country:US
Practice Address - Phone:910-338-8711
Practice Address - Fax:910-793-6140
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC121101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral