Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0101248740 | VA |
N | 208600000X | Surgeon | 0101248740 | VA |
N | 2086S0122X | Plastic and Reconstructive Surgery | 283325 | NY |
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME135896 | FL |
NPI | 1326205238 |
---|---|
Provider Name | Kristopher Blake Hamwi |
First Address | Tampa, FL 33615 |
Second Address | Tampa, FL 33615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2008 |
Last Update Date | 27/09/2019 |