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Individual
BETHANN HAMM
Active
Individual
BETHANN HAMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS010312L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017383790002
—
PA
Enumeration date
06/10/2005
Last updated
01/11/2011
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