Provider Demographics
NPI:1265069488
Name:HAMILTON MEDICAL & ASSOCIATES
Entity type:Organization
Organization Name:HAMILTON MEDICAL & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TYWANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:410-855-4448
Mailing Address - Street 1:124 SLADE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4900
Mailing Address - Country:US
Mailing Address - Phone:410-855-4448
Mailing Address - Fax:
Practice Address - Street 1:124 SLADE AVE STE 101
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4900
Practice Address - Country:US
Practice Address - Phone:410-855-4448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALING MIND WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-26
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty