Provider Demographics
NPI:1073540886
Name:HAMMER, ELIZABETH P (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:P
Last Name:HAMMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:636-649-3085
Mailing Address - Fax:636-649-3087
Practice Address - Street 1:1935 PRAIRIE DELL RD STE 400
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-4327
Practice Address - Country:US
Practice Address - Phone:636-649-3085
Practice Address - Fax:363-649-3087
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2003020132208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207243809Medicaid
929742943Medicare ID - Type Unspecified
MO207243809Medicaid