Provider Demographics
NPI:1346393261
Name:HAMRICK, MILLER CARLTON (MD)
Entity type:Individual
Prefix:DR
First Name:MILLER
Middle Name:CARLTON
Last Name:HAMRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 WATERS AVE STE 307
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6268
Mailing Address - Country:US
Mailing Address - Phone:912-350-7914
Mailing Address - Fax:912-350-7973
Practice Address - Street 1:4750 WATERS AVE STE 307
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404
Practice Address - Country:US
Practice Address - Phone:912-350-7914
Practice Address - Fax:912-350-7973
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0656712086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGA1597Medicaid
GA003109566FMedicaid
GAP01292127OtherRAILROAD MEDICARE
GA202I022594Medicare PIN