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Individual

AMY HAMILTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
Mailing address
PO BOX 1309, MS 21110Q, MINNEAPOLIS, MN 55440-1309
(952) 883-7172

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10969
MN
363A00000X
Physician Assistant
PA9102727
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2918811-00
FL
05
ENROLLED
MN
01
P01045289
RAILROAD MEDICARE
MN
01
U2774Y
MEDICARE SOUTH GULF
FL
01
U2774Z
MEDICARE SOUTHWEST
FL
Enumeration date
02/03/2006
Last updated
04/07/2017
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