MEDICARE: DR. WILLIAM JOHN HAMMERASH JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D0055926	MD

General Provider Information

NPI Number	:	1033110390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM JOHN HAMMERASH JR. M.D.

Provider Business Mailing Address
First Line	:	5106 BONNIE BRANCH RD
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-7034
Country	:	US
Telephone Number	:	410-480-5013
Fax Number	:

Provider Business Practice Location Address
First Line	:	708C LISBON CENTER DR
Second Line	:
City	:	WOODBINE
State	:	MD
Zip	:	21797-8600
Country	:	US
Telephone Number	:	410-489-7777
Fax Number	:	410-795-8920

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/08/2007

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