Provider Demographics
NPI:1952521882
Name:HUMMERS, EDWARD W IV (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:W
Last Name:HUMMERS
Suffix:IV
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6812 CHERRY TREE CT
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6702
Mailing Address - Country:US
Mailing Address - Phone:301-865-1451
Mailing Address - Fax:
Practice Address - Street 1:11717 OLD NATIONAL PIKE
Practice Address - Street 2:STE. 7
Practice Address - City:NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21774-6154
Practice Address - Country:US
Practice Address - Phone:301-831-3633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD098811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice