Provider Demographics
NPI:1598771297
Name:JHAMB, KRISTIN K (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:K
Last Name:JHAMB
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 1:1 WELLNESS WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1768
Mailing Address - Country:US
Mailing Address - Phone:207-406-7600
Mailing Address - Fax:207-406-7601
Practice Address - Street 1:1 WELLNESS WAY
Practice Address - Street 2:SUITE A
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1768
Practice Address - Country:US
Practice Address - Phone:207-406-7600
Practice Address - Fax:207-406-7601
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME014728207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F82735Medicare UPIN
MEMM7286Medicare PIN