Provider Demographics
NPI:1306989173
Name:HAMEL, DAVID M
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:HAMEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2754 WEAVERTON
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4660
Mailing Address - Country:US
Mailing Address - Phone:248-321-9305
Mailing Address - Fax:
Practice Address - Street 1:36150 DEQUINDRE RD
Practice Address - Street 2:SUITE 530
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-7149
Practice Address - Country:US
Practice Address - Phone:248-321-9305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801015866106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM10220Medicare ID - Type Unspecified