Individual
MR. NICHOLAS J HAMMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
604 W BERRY ST, FORT WAYNE, IN 46802-2106
(260) 423-1331
Mailing address
604 W BERRY ST, FORT WAYNE, IN 46802-2106
(260) 423-1331
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10000887A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10000887A
IN LICENSE
IN
Enumeration date
01/15/2008
Last updated
01/15/2008
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