Provider Demographics
NPI:1538490552
Name:HAMMOND, ANDRAE JEROMW SR
Entity Type:Individual
Prefix:MR
First Name:ANDRAE
Middle Name:JEROMW
Last Name:HAMMOND
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 SOUTHVIEW DR
Mailing Address - Street 2:SUITE T8
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-4110
Mailing Address - Country:US
Mailing Address - Phone:202-270-0617
Mailing Address - Fax:202-506-3589
Practice Address - Street 1:1314 SOUTHVIEW DR
Practice Address - Street 2:SUITE T8
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-4110
Practice Address - Country:US
Practice Address - Phone:202-270-0617
Practice Address - Fax:202-506-3589
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health