MEDICARE: CRAIG STEPHEN HAMMES 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	2085N0904X	Nuclear Radiology Physician	32568	CO
2	2085R0202X	Diagnostic Radiology Physician	32568	CO
3	2085R0204X	Vascular & Interventional Radiology Physician	32568	CO
4	2085U0001X	Diagnostic Ultrasound Physician	32568	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	483724787	OTHER		CHAMPUS
2	HAC2708	OTHER	CO	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	841184495001	OTHER	CO	RMHP
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639163843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG STEPHEN HAMMES M.D.

Provider Business Mailing Address
First Line	:	11995 SINGLETREE LN
Second Line	:	SUITE 500
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-5347
Country	:	US
Telephone Number	:	952-595-1242
Fax Number	:	952-935-2757

Provider Business Practice Location Address
First Line	:	885 1650 LN
Second Line	:
City	:	DELTA
State	:	CO
Zip	:	81416-8107
Country	:	US
Telephone Number	:	952-595-1242
Fax Number	:	952-935-2757

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

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	03/12/2009

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