Provider Demographics
NPI:1861638330
Name:HAMILTON, MICHAEL E (LIC AC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 GOLDEN RIVER DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2427
Mailing Address - Country:US
Mailing Address - Phone:561-689-7113
Mailing Address - Fax:
Practice Address - Street 1:441 GOLDEN RIVER DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2427
Practice Address - Country:US
Practice Address - Phone:561-689-7113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA353171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist