Healthcare Provider Details

I. General information

NPI: 1518232735
Provider Name (Legal Business Name): JAMES M HAMMOND JR. CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 PARK CENTER CT STE 100
OWINGS MILLS MD
21117-0358
US

IV. Provider business mailing address

PO BOX 784305
PHILADELPHIA PA
19178-4305
US

V. Phone/Fax

Practice location:
  • Phone: 855-527-7246
  • Fax: 866-229-5063
Mailing address:
  • Phone: 844-565-6473
  • Fax: 302-733-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR171923
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN1010072
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: