Provider Demographics
NPI:1619198637
Name:ALI HAMM, ANDREW (ACUP PHYSICIAN)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:ALI HAMM
Suffix:
Gender:M
Credentials:ACUP PHYSICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 SW 91ST ST
Mailing Address - Street 2:SUITE 110-81
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-2781
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2783 SW 87TH DR
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-9370
Practice Address - Country:US
Practice Address - Phone:352-727-8812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2499171100000X
MA220208171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist