Healthcare Provider Details

I. General information

NPI: 1295700920
Provider Name (Legal Business Name): MARC RONALD HAMET M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 DIALSTONE LN
RIVERSIDE CT
06878-1701
US

IV. Provider business mailing address

20 DIALSTONE LN
RIVERSIDE CT
06878-1701
US

V. Phone/Fax

Practice location:
  • Phone: 203-912-4574
  • Fax:
Mailing address:
  • Phone: 203-912-4574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number36674
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME149181
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME149181
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number36674
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberD0043805
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number36674
License Number StateCT
# 7
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberD0043805
License Number StateMD
# 8
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberME149181
License Number StateFL
# 9
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD0043805
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: