Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD010804E | PA |
NPI | 1083971030 |
---|---|
Provider Name | N Leroy Hammond III |
First Address | Gladwyne, PA 19035-1543 |
Second Address | Gladwyne, PA 19035-1543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2012 |
Last Update Date | 16/04/2012 |