Organization Name: | HAMLET HMA PPM LLC |
NPI Number: | 1043589815 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL L GINGRAS (VICE PRESIDENT) |
Mailing Address: | 104 Rice St Hamlet |
State: | NC US |
Postal Code: | 283453304 |
Phone Number: | 9105826712 |
Fax Number: | |
NPI Enumeration Date: | 12/22/2011 |
NPI Last Update Date: | 11/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |