Provider Demographics
NPI:1467492488
Name:HAMMETT, ROCHELLE (MD)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:
Last Name:HAMMETT
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:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-1239
Mailing Address - Country:US
Mailing Address - Phone:248-824-6622
Mailing Address - Fax:248-324-1477
Practice Address - Street 1:7350 INDUSTRIAL PARK BLVD
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5318
Practice Address - Country:US
Practice Address - Phone:216-732-9480
Practice Address - Fax:440-942-8431
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35078805207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2235174Medicaid
OH2084373Medicaid
OH2084373Medicaid
OHHA4181505Medicare ID - Type Unspecified