Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 042-0008974 | VT |
Y | 207N00000X | Dermatologist | 9247 | NH |
NPI | 1063456226 |
---|---|
Provider Name | Dr. Charles John Hammer III |
First Address | Littleton, NH 03561-3437 |
Second Address | Littleton, NH 03561-3437 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 29/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0RE3223 | (05) | VT |
80003223 | (05) | NH |
F96015 | (02) |