Provider Demographics
NPI:1205849668
Name:HAMMEL, IRIANA S (MD)
Entity Type:Individual
Prefix:DR
First Name:IRIANA
Middle Name:S
Last Name:HAMMEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:IRIANA
Other - Middle Name:S
Other - Last Name:HAMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1000 HOUGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-5303
Mailing Address - Country:US
Mailing Address - Phone:989-583-6812
Mailing Address - Fax:989-583-6915
Practice Address - Street 1:1201 NW 16TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1624
Practice Address - Country:US
Practice Address - Phone:305-575-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081111207RG0300X
FLME109215207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIIH081111OtherLICENSE NUMBER
MI381870664OtherTAX ID
700G360210OtherBCBSM GROUP PIN
01005357OtherHEALTHPLUS OF MICHIGAN
P00381891OtherRAILROAD MEDICARE
MI1205849668Medicaid
144006OtherGREAT LAKES HEALTH PLAN
01005357OtherHEALTHPLUS OF MICHIGAN
144006OtherGREAT LAKES HEALTH PLAN