Provider Demographics
NPI:1154331908
Name:HAMMETT, CAROLYN AGNES (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:AGNES
Last Name:HAMMETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 SLIGO CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5810
Mailing Address - Country:US
Mailing Address - Phone:301-431-4030
Mailing Address - Fax:301-431-4826
Practice Address - Street 1:1835 UNIVERSITY BLVD E
Practice Address - Street 2:SUITE 226
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4600
Practice Address - Country:US
Practice Address - Phone:301-431-4030
Practice Address - Fax:301-431-4826
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0039966207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0H36CA52078700OtherBC MD
MD264118OtherUHC
DC40090001OtherBC DC METRO
MD019941900Medicaid
MD0H36CA52078700OtherBC MD
E56817Medicare UPIN