Provider Demographics
NPI:1457455941
Name:HAMMERBERG, ERIC MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:MARK
Last Name:HAMMERBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:MC 0188
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4507
Mailing Address - Country:US
Mailing Address - Phone:303-436-6000
Mailing Address - Fax:303-602-1664
Practice Address - Street 1:240 HOSPITAL PL STE 204B
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7559
Practice Address - Country:US
Practice Address - Phone:907-714-4120
Practice Address - Fax:844-412-3943
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA053751207X00000X
CAA97623207X00000X
GA53751207XX0801X
CO46249207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07575726Medicaid
CO07575726Medicaid
CO300359Medicare PIN