MEDICARE: CAROLYN A. HAMMETT MD PC

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	207Q00000X	Family Medicine Physician	D39966	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	264118	OTHER	MD	UNITED HEALTHCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0H36CA52078700	OTHER	MD	BC MD
4	40090001	OTHER	DC	BC DC/METRO

General Provider Information

NPI Number	:	1861678229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLYN A. HAMMETT MD PC

Provider Business Mailing Address
First Line	:	901 SLIGO CREEK PKWY
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-5810
Country	:	US
Telephone Number	:	410-848-8202
Fax Number	:	410-848-2644

Provider Business Practice Location Address
First Line	:	1835 UNIVERSITY BLVD E
Second Line	:	#226
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-4600
Country	:	US
Telephone Number	:	410-848-8202
Fax Number	:	410-848-2644

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	SUE DAVIS
Credential	:
Telephone Number	:	410-848-8202

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	04/28/2008

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