MEDICARE: GLOBAL TRAVEL HEALTH PROFESSIONAL, LLC

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	174400000X	Specialist	30415	CO

General Provider Information

NPI Number	:	1922233196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL TRAVEL HEALTH PROFESSIONAL, LLC

Provider Business Mailing Address
First Line	:	4545 E 9TH AVE STE 120
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-3902
Country	:	US
Telephone Number	:	303-468-6986
Fax Number	:	303-320-1953

Provider Business Practice Location Address
First Line	:	4545 E 9TH AVE STE 120
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-3902
Country	:	US
Telephone Number	:	303-468-6986
Fax Number	:	303-320-1953

Authorized Official
Title or Position	:	34 OWNER
Name	:	DR. JOHN HAMMER
Credential	:	M.D.
Telephone Number	:	303-468-6986

Provider Enumeration Date	:	05/18/2009
Last Update Date	:	05/18/2009

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