Provider Demographics
NPI:1679193080
Name:HAMMER, BEVERLY ELAINE (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ELAINE
Last Name:HAMMER
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 STONELEIGH RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-1631
Mailing Address - Country:US
Mailing Address - Phone:443-765-0945
Mailing Address - Fax:
Practice Address - Street 1:802 STONELEIGH RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-1631
Practice Address - Country:US
Practice Address - Phone:443-765-0945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-26
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1674133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist