Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 84803 | GA |
NPI | 1003267790 |
---|---|
Provider Name | Christina Marie Hamilton |
First Address | Atlanta, GA 30310-2533 |
Second Address | Grand Rapids, MI 49503-2556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2016 |
Last Update Date | 01/07/2020 |