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NPI Code Detail

MEDICARE: MICHAEL DAVID HAMMOND PA-C

MEDICARE:   MICHAEL DAVID HAMMOND  PA-C
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
1363A00000XPhysician Assistant10866GA

General Provider Information

NPI Number : 1699410688
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL DAVID HAMMOND PA-C
Provider Business Mailing Address
First Line : 2041 MESA VALLEY WAY STE 100
Second Line :
City : AUSTELL
State : GA
Zip : 30106-6856
Country : US
Telephone Number : 770-944-1100
Fax Number : 770-944-6469
Provider Business Practice Location Address
First Line : 2041 MESA VALLEY WAY STE 100
Second Line :
City : AUSTELL
State : GA
Zip : 30106-6856
Country : US
Telephone Number : 770-944-1100
Fax Number : 770-944-6469
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2022
Last Update Date : 05/03/2022

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Directions to “ MICHAEL DAVID HAMMOND PA-C” Practice Location

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