Provider Demographics
NPI:1235107152
Name:HAMER, MARK E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:HAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:140 CANAL VIEW BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2808
Mailing Address - Country:US
Mailing Address - Phone:585-338-2700
Mailing Address - Fax:585-242-9663
Practice Address - Street 1:140 CANAL VIEW BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2808
Practice Address - Country:US
Practice Address - Phone:585-338-2700
Practice Address - Fax:585-242-9663
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY171572207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
301124OtherWELLCARE
PO10171572OtherGRIPA
RC60171572OtherRCIPA
9701200OtherGHI
MDF054OtherPREFERRED CARE
0001267313OtherUNITED HEALTHCARE
005259871OtherCOMM. BLUE/BCBSWNY
4627874OtherAETNA
7701226OtherMVP
000525987001OtherHEALTH NOW PARNALL
060059697OtherRAILROAD MEDICARE
NY02066071Medicaid
000525987004OtherHEALTH NOW LINDEN
PO10171572OtherEXCELLUS
6890OtherBCBS
MDF054OtherPREFERRED CARE
MDF054OtherPREFERRED CARE