Provider Demographics
NPI:1033110390
Name:HAMMERASH, WILLIAM JOHN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:HAMMERASH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5106 BONNIE BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7034
Mailing Address - Country:US
Mailing Address - Phone:410-480-5013
Mailing Address - Fax:
Practice Address - Street 1:708C LISBON CENTER DR
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:MD
Practice Address - Zip Code:21797-8600
Practice Address - Country:US
Practice Address - Phone:410-489-7777
Practice Address - Fax:410-795-8920
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055926207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G00114010360M14Medicare ID - Type Unspecified
H20366Medicare UPIN