Healthcare Provider Details

I. General information

NPI: 1033872171
Provider Name (Legal Business Name): RHYCE DANIEL HAMMAKER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 10/15/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 N 21ST ST
CAMP HILL PA
17011-2204
US

IV. Provider business mailing address

890 POPLAR CHURCH RD STE 210
CAMP HILL PA
17011-2250
US

V. Phone/Fax

Practice location:
  • Phone: 717-763-2100
  • Fax:
Mailing address:
  • Phone: 717-761-7244
  • Fax: 717-761-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA063072
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: