Provider Demographics
NPI:1316208317
Name:MICHAEL W. HAMMER,O.D. INC.
Entity Type:Organization
Organization Name:MICHAEL W. HAMMER,O.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-677-2840
Mailing Address - Street 1:2480 SOCIALVILLE FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9305
Mailing Address - Country:US
Mailing Address - Phone:513-677-3880
Mailing Address - Fax:513-677-3880
Practice Address - Street 1:126 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1918
Practice Address - Country:US
Practice Address - Phone:513-677-2840
Practice Address - Fax:513-677-2840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3773T58152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000014088OtherBLUE CROSS BLUE SHIELD
OH0598214Medicaid
OH0598214Medicaid
OH000000014088OtherBLUE CROSS BLUE SHIELD
OHP48388Medicare UPIN
OHMI0582233Medicare PIN
OHHA0582233Medicare PIN