Individual
JEANETTE HAMMERSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4011 S MONROE MEDICAL PARK BLVD, BLOOMINGTON, IN 47403-8000
(812) 825-1111
Mailing address
4011 S MONROE MEDICAL PARK BLVD, BLOOMINGTON, IN 47403-8000
(812) 825-1111
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
4301080228
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841211042
UNSPECIFIED
—
Enumeration date
07/22/2006
Last updated
10/01/2014
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