Provider Demographics
NPI:1366761595
Name:HAMEL, MICHELLE GRACE (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:GRACE
Last Name:HAMEL
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 1:7930 FROST ST STE 204
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2739
Mailing Address - Country:US
Mailing Address - Phone:858-565-0104
Mailing Address - Fax:858-939-3213
Practice Address - Street 1:7930 FROST ST STE 204
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-565-0104
Practice Address - Fax:858-939-3213
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1368652086S0127X, 2086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care