Provider Demographics
NPI:1144003187
Name:HAMILTON, MICHAEL GBENGA (MB;BS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GBENGA
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:MB;BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ALBERT EINSTEIN MEDICAL CENTER
Mailing Address - Street 2:5501 OLD YORK ROAD
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141
Mailing Address - Country:US
Mailing Address - Phone:215-456-6500
Mailing Address - Fax:
Practice Address - Street 1:ALBERT EINSTEIN MEDICAL CENTRE
Practice Address - Street 2:5501 OLD YORK ROAD
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141
Practice Address - Country:US
Practice Address - Phone:215-456-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2024-03-18
Deactivation Date:2024-03-18
Deactivation Code:
Reactivation Date:2024-03-18
Provider Licenses
StateLicense IDTaxonomies
PAMT228460207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine