MEDICARE: CAROLYN AGNES HAMMETT MD

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	207R00000X	Internal Medicine Physician	D0039966	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0H36CA52078700	OTHER	MD	BC MD
2	264118	OTHER	MD	UHC
3	40090001	OTHER	DC	BC DC METRO
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154331908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN AGNES HAMMETT MD

Provider Business Mailing Address
First Line	:	901 SLIGO CREEK PKWY
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-5810
Country	:	US
Telephone Number	:	301-431-4030
Fax Number	:	301-431-4826

Provider Business Practice Location Address
First Line	:	1835 UNIVERSITY BLVD E
Second Line	:	SUITE 226
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-4600
Country	:	US
Telephone Number	:	301-431-4030
Fax Number	:	301-431-4826

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	06/12/2008

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