Basic Information
Provider Information
NPI: 1043958044
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMILTON
FirstName: ALSTON
MiddleName: JAMES
NamePrefix:  
NameSuffix:  
Credential: CRNA, DNAP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 751461
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282751461
CountryCode: US
TelephoneNumber: 8437926200
FaxNumber:  
Practice Location
Address1: 25 COURTENAY DR
Address2:  
City: CHARLESTON
State: SC
PostalCode: 294258911
CountryCode: US
TelephoneNumber: 8437922300
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/20/2022
LastUpdateDate: 08/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X137166SCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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