Provider Demographics
NPI:1144333550
Name:HAMEL, PETER C (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:C
Last Name:HAMEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8641 COUNTY ROAD 404
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-6563
Mailing Address - Country:US
Mailing Address - Phone:573-248-0404
Mailing Address - Fax:
Practice Address - Street 1:109 VIRGINIA ST
Practice Address - Street 2:SUITE 110
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-3778
Practice Address - Country:US
Practice Address - Phone:573-248-0826
Practice Address - Fax:573-221-2252
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9331207ZP0102X
WI22695207ZP0102X
MI4301088853207ZP0102X
IL207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1C220009505OtherRAILROAD MEDICARE
D33997Medicare UPIN