Provider Demographics
NPI:1952845836
Name:HAMILTON, DORA
Entity Type:Individual
Prefix:MS
First Name:DORA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DORA
Other - Middle Name:
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2275 BRINDLE ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-3502
Mailing Address - Country:US
Mailing Address - Phone:401-699-7027
Mailing Address - Fax:
Practice Address - Street 1:2275 BRINDLE ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27107-3502
Practice Address - Country:US
Practice Address - Phone:401-699-7027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide