Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 16515 | NC |
NPI | 1033193495 |
---|---|
Provider Name | John William Hammon |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 08/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2124 | PARTNERS (01) | |
3810003390 | (05) | WV |
38851 | BCBS (01) | |
40840 | MEDCOST (01) | |
4245060 | AETNA (01) | |
7441339 | (05) | VA |
8938851 | (05) | NC |
D70214 | (02) | |
Q16515 | (05) | SC |