Healthcare Provider Details

I. General information

NPI: 1851745335
Provider Name (Legal Business Name): MICHAEL ANDREW HAMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 VILLAGE PROFESSIONAL DR
OPELIKA AL
36801-2380
US

IV. Provider business mailing address

2570 VILLAGE PROFESSIONAL DR
OPELIKA AL
36801-2380
US

V. Phone/Fax

Practice location:
  • Phone: 334-203-1917
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD.36563
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: