Provider Demographics
NPI:1033211271
Name:HAMMOND, CYNTHIA B (RD LDN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:B
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7225 TALL TREE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-2240
Mailing Address - Country:US
Mailing Address - Phone:704-393-1815
Mailing Address - Fax:704-393-1815
Practice Address - Street 1:7225 TALL TREE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-2240
Practice Address - Country:US
Practice Address - Phone:704-393-1815
Practice Address - Fax:704-393-1815
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000584133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC142KAOtherBCBSNC
2991322Medicare PIN