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General NPI Number Information
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NPI Number | 1386764504
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Entity Type | Individual
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Provider Name | CLARISA C. HAMMER DO
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 4660 KENMORE AVE STE 220
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1306
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Country | US
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Telephone | 703-832-4000
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Fax | 703-832-4001
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Provider Business Mailing Address
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Address Line | 4660 KENMORE AVE STE 220
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1306
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Country | US
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Telephone | 703-832-4000
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Fax | 443-481-6515
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 34009035
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 20A10466
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | H75038
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 0102203916
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License Number State | VA
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