Provider Demographics
NPI:1720974033
Name:HAMELIN, EMMANUEL (DO)
Entity type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:
Last Name:HAMELIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 POINTE GRAND DR # 3101
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-4864
Mailing Address - Country:US
Mailing Address - Phone:418-271-9324
Mailing Address - Fax:418-271-9324
Practice Address - Street 1:1400 POINTE GRAND DR # 3101
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-4864
Practice Address - Country:US
Practice Address - Phone:418-271-9324
Practice Address - Fax:418-271-9324
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA244141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice