Provider Demographics
NPI:1508813478
Name:HAMMAN, CHELSEA COFFEY (MD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:COFFEY
Last Name:HAMMAN
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 1:1616 N MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4474
Mailing Address - Country:US
Mailing Address - Phone:276-783-1827
Mailing Address - Fax:276-783-2879
Practice Address - Street 1:1616 N MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-4398
Practice Address - Country:US
Practice Address - Phone:276-783-8123
Practice Address - Fax:276-783-1820
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239761207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA199528OtherANTHEM
VAP01597972OtherRR MEDICARE
VA1508813478Medicaid
VA515405OtherSOUTHERN HEALTH
VAI54553Medicare UPIN
VAVVE180AMedicare PIN