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General NPI Number Information
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NPI Number | 1073163044
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Entity Type | Individual
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Provider Name | MICHAEL T HAM RN
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Gender | Male
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Dates
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Enumeration Date | 09/12/2019
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Last Update Date | 09/12/2019
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Provider Practice Location Address
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Address Line | 23 MORRIS AVE STE 219
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City | BRYN MAWR
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State | PA
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Zip | 19010-3335
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Country | US
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Telephone | 215-662-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1337 POTTSTOWN PIKE
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City | WEST CHESTER
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State | PA
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Zip | 19380-1235
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Country | US
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Telephone | 484-883-6827
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN604865
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License Number State | PA
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