Provider Demographics
NPI:1316161417
Name:HAMILTON, SHEILA KAY
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:KAY
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 N MYERS RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041-7705
Mailing Address - Country:US
Mailing Address - Phone:440-415-0575
Mailing Address - Fax:
Practice Address - Street 1:5130 N MYERS RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-7705
Practice Address - Country:US
Practice Address - Phone:440-415-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0953544Medicaid