Provider Demographics
NPI:1336126549
Name:HAMMAR, EILEEN K (MD)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:K
Last Name:HAMMAR
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 1:291 W SCHROCK RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2874
Mailing Address - Country:US
Mailing Address - Phone:614-901-2273
Mailing Address - Fax:614-901-3140
Practice Address - Street 1:291 W SCHROCK RD
Practice Address - Street 2:SUITE A
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2874
Practice Address - Country:US
Practice Address - Phone:614-901-2273
Practice Address - Fax:614-901-3140
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-08-1239207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2342478Medicaid
OH2342478Medicaid
OH4084312Medicare PIN