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Individual

RYAN HAMM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 544-5311
(262) 544-6820
Mailing address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 303-5055
(262) 303-5057

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3706-23
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1265812853
WI
Enumeration date
06/09/2015
Last updated
12/06/2019
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