Individual
MR. MARK R. HAMMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., CCC-SLP
Contact information
Practice address
222 AUBURN ST, SUITE 1G, PORTLAND, ME 04103-6004
(207) 797-8255
(200) 779-7556
Mailing address
222 AUBURN ST, SUITE 1G, PORTLAND, ME 04103-6004
(207) 797-8255
(207) 797-5560
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP131
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010512139
TAX ID
ME
01
—
018316
ANTHEM ID
ME
05
—
130820099
—
ME
01
—
AA28449
HARVARD PILGRIM ID
ME
Enumeration date
08/20/2006
Last updated
10/07/2009
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