MEDICARE: RACHEL HAMMOUDEH O.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	152W00000X	Optometrist	030.0133938	VT
2	152W00000X	Optometrist	10144	TX
3	152W00000X	Optometrist	007211	OH
4	152W00000X	Optometrist	0003364	CO
5	152W00000X	Optometrist	002250	AZ

General Provider Information

NPI Number	:	1114449659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL HAMMOUDEH O.D.

Provider Business Mailing Address
First Line	:	2435 COMMERCE AVE BLDG 2200
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-4980
Country	:	US
Telephone Number	:	678-892-3778
Fax Number	:

Provider Business Practice Location Address
First Line	:	2435 COMMERCE AVE BLDG 2200
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-4980
Country	:	US
Telephone Number	:	678-892-3778
Fax Number	:

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

Provider Enumeration Date	:	07/15/2017
Last Update Date	:	04/04/2025

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