Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 95 | SC |
NPI | 1093886962 |
---|---|
Provider Name | Scott A Hamilton |
First Address | Myrtle Beach, SC 29572-4128 |
Second Address | Myrtle Beach, SC 29572-4128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 01/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GP9984 | (05) | SC |
T24473 | (02) | SC |