Provider Demographics
NPI:1912431776
Name:HAMILTON, NATHAN ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ROBERT
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3495 S CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48519-1455
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7477 S STATE RD
Practice Address - Street 2:
Practice Address - City:GOODRICH
Practice Address - State:MI
Practice Address - Zip Code:48438-8745
Practice Address - Country:US
Practice Address - Phone:810-636-2235
Practice Address - Fax:810-636-3008
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101022988207Q00000X
MI5101025831207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine