Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | D0063660 | MD |
NPI | 1033271697 |
---|---|
Provider Name | Dr. Jason Wilson Hammond |
First Address | Ellicott City, MD 21043-7973 |
Second Address | Baltimore, MD 21218-2867 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |