Provider Demographics
NPI:1952525321
Name:HAMMER, HANS M (MS, R D, LD)
Entity type:Individual
Prefix:
First Name:HANS
Middle Name:M
Last Name:HAMMER
Suffix:
Gender:M
Credentials:MS, R D, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0058
Mailing Address - Country:US
Mailing Address - Phone:770-535-5874
Mailing Address - Fax:770-531-4544
Practice Address - Street 1:1280 ATHENS ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-7000
Practice Address - Country:US
Practice Address - Phone:770-535-5874
Practice Address - Fax:770-531-4544
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QP0905X133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric