Provider Demographics
NPI:1780770792
Name:HAMNER, LEWIS H III (MD)
Entity type:Individual
Prefix:
First Name:LEWIS
Middle Name:H
Last Name:HAMNER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHIP
Other - Middle Name:
Other - Last Name:HAMNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-364-7000
Mailing Address - Fax:
Practice Address - Street 1:20 GLENLAKE PKWY NE
Practice Address - Street 2:MATERNAL - FETAL MEDICINE / OBGYN
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:770-677-6116
Practice Address - Fax:770-677-7331
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030781207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
16BBCQSMedicare ID - Type Unspecified
D45541Medicare UPIN