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Individual

DR. MARC RANDALL HAMMERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4570 CHILDRENS PL, SAINT LOUIS, MO 63110-1020
(314) 362-7601
(314) 362-0186
Mailing address
660 S EUCLID AVE, C B 8126, SAINT LOUIS, MO 63110-1010
(314) 362-7601
(314) 362-0186

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
R7960
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0280272040
IL
05
054010183
MO
Enumeration date
07/18/2006
Last updated
10/22/2015
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