Provider Demographics
NPI:1437157187
Name:HAMMERSMITH, KRISTIN MEREDITH (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MEREDITH
Last Name:HAMMERSMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:MATELIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:125 S 9TH ST STE 402
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5117
Mailing Address - Country:US
Mailing Address - Phone:267-546-1100
Mailing Address - Fax:267-200-0679
Practice Address - Street 1:125 S 9TH ST STE 402
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5117
Practice Address - Country:US
Practice Address - Phone:267-546-1100
Practice Address - Fax:267-200-0679
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07668200207W00000X
PAMD419569207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019370960002Medicaid
PA1444179OtherBLUE SHEILD
322 1147OtherAETNA
PA1444179OtherBLUE SHEILD
PA063129Medicare UPIN
H71414Medicare UPIN