Provider Demographics
NPI:1699745570
Name:HAMILTON, ELIZABETH HARRIS (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:HARRIS
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 MEDICAL PARK DRIVE
Mailing Address - Street 2:SUITE NUMBER 102
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704
Mailing Address - Country:US
Mailing Address - Phone:919-220-7546
Mailing Address - Fax:919-220-5805
Practice Address - Street 1:4321 MEDICAL PARK DRIVE
Practice Address - Street 2:SUITE NUMBER 102
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704
Practice Address - Country:US
Practice Address - Phone:919-220-7546
Practice Address - Fax:919-220-5805
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35359207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1043WOtherBCBS OF NORTH CAROLINA
NC891043WMedicaid
NC0352359OtherUNITEDHEALTH CARE
NC73115OtherMEDCOST
NCF79803Medicare UPIN
NC2236429Medicare PIN