Provider Demographics
NPI:1235218363
Name:HAMMER, CARL STEVENS (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:STEVENS
Last Name:HAMMER
Suffix:
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 1:101 E. 26TH STREET
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98421-1108
Mailing Address - Country:US
Mailing Address - Phone:253-597-4550
Mailing Address - Fax:253-383-2596
Practice Address - Street 1:1708 EAST 44TH STREET
Practice Address - Street 2:EASTSIDE TANBARA MEDICAL
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404
Practice Address - Country:US
Practice Address - Phone:253-471-4553
Practice Address - Fax:253-474-5396
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00010966208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1983778Medicaid
WA1983778Medicaid
AB33393Medicare ID - Type Unspecified