Provider Demographics
NPI:1962727875
Name:HAMILTON, ZACHARY ADAM (MD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:ADAM
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 S. SPRING AVE
Mailing Address - Street 2:SLU ACADEMIC PAVILION
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110
Mailing Address - Country:US
Mailing Address - Phone:314-977-3470
Mailing Address - Fax:314-977-1642
Practice Address - Street 1:3655 VISTA AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2539
Practice Address - Country:US
Practice Address - Phone:314-977-4440
Practice Address - Fax:314-977-1642
Is Sole Proprietor?:No
Enumeration Date:2010-04-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017002244208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology