Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 222 | NC |
N | 213ES0103X | Foot & Ankle Surgery | 222 | NC |
NPI | 1114085321 |
---|---|
Provider Name | Dr. Valentine T Hamilton |
First Address | Jacksonville, NC 28546-6304 |
Second Address | Jacksonville, NC 28546-6304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 09/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08055 | BCBS OF NC (01) | |
561601771 | TAX ID (01) | |
8908055 | (05) | NC |
T64077 | (02) |