MEDICARE: HAMMETT CLINIC, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center	26144	SC

General Provider Information

NPI Number	:	1639524432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMMETT CLINIC, PA

Provider Business Mailing Address
First Line	:	3710 LANDMARK DR
Second Line	:	SUITE 114
City	:	COLUMBIA
State	:	SC
Zip	:	29204-4062
Country	:	US
Telephone Number	:	803-391-5918
Fax Number	:

Provider Business Practice Location Address
First Line	:	3710 LANDMARK DR
Second Line	:	SUITE 114
City	:	COLUMBIA
State	:	SC
Zip	:	29204-4062
Country	:	US
Telephone Number	:	803-391-5918
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID HALL HAMMETT
Credential	:	MD
Telephone Number	:	803-467-8969

Provider Enumeration Date	:	04/29/2016
Last Update Date	:	10/03/2016

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