Individual
DR. HARLEY J HAMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11615 OLIVE BLVD, CREVE COEUR, MO 63141-7095
(314) 993-9555
(314) 993-9550
Mailing address
11615 OLIVE BLVD, METRO IMAGING, SAINT LOUIS, MO 63141-7095
(314) 993-9555
(314) 432-0178
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036058699
IL
2085R0202X
Diagnostic Radiology Physician
Primary
R6869
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036058699
—
IL
05
—
201203502
—
MO
01
—
300099491
RAILROAD MEDICARE NUMBER
IL
01
—
300102475
RAILROAD MEDICARE NUMBER
MO
Enumeration date
07/14/2006
Last updated
08/25/2010
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