Healthcare Provider Details

I. General information

NPI: 1235232364
Provider Name (Legal Business Name): STEVEN C HAMMOND PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1185 US HIGHWAY 23 N
ALPENA MI
49707-8018
US

IV. Provider business mailing address

1185 US HIGHWAY 23 N P.O. BOX 857
ALPENA MI
49707-8018
US

V. Phone/Fax

Practice location:
  • Phone: 989-356-4049
  • Fax: 989-356-6287
Mailing address:
  • Phone: 989-356-4049
  • Fax: 989-356-6287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601004244
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: