Basic Information
| Provider Information | |||||||||
| NPI: | 1437140639 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMMOND | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13303 TESSON FERRY RD | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631284062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3148424744 | ||||||||
| FaxNumber: | 3148423835 | ||||||||
| Practice Location | |||||||||
| Address1: | 13303 TESSON FERRY RD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631284062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3148424744 | ||||||||
| FaxNumber: | 3148423835 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2005 | ||||||||
| LastUpdateDate: | 09/21/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 102276 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000010017 | 01 | ESSENCE | OTHER | 0400752 | 01 | UHC | OTHER | F54539 | 01 | MERCY HEALTH | OTHER | 112556 | 01 | BCBS | OTHER | 92215275 | 01 | BLUE SHIELD | OTHER | 1037488 | 01 | AETNA US HEALTHCARE | OTHER | 127434 | 01 | GHP | OTHER | 4000423 | 01 | AETNA | OTHER | 188364 | 01 | HEALTHLINK | OTHER |