Healthcare Provider Details

I. General information

NPI: 1639515612
Provider Name (Legal Business Name): LAURA JOYE HAMMON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA JOYE HAMMON M.D.

II. Dates (important events)

Enumeration Date: 05/16/2013
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WRNMMC, BLDG 19 4TH FLR, PEDS SUBSPECIALTY CLINIC 4954 NORTH PALMER RD
BETHESDA MD
20889-5630
US

IV. Provider business mailing address

WRNMMC, BLDG 19 4TH FLR, PEDS SUBSPECIALTY CLINIC 4954 NORTH PALMER RD
BETHESDA MD
20889-5630
US

V. Phone/Fax

Practice location:
  • Phone: 301-400-1667
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20140332443
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number0101259549
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number2014032443
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: