Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 0101244466 | VA |
NPI | 1003939737 |
---|---|
Provider Name | Mark D Hamilton |
First Address | Roanoke, VA 24038-3888 |
Second Address | Salem, VA 24153-7474 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 27/01/2011 |