Basic Information
Provider Information
NPI: 1104152883
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMMOND
FirstName: DAVID
MiddleName:  
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 5000 CHESHIRE PKWY N
Address2:  
City: PLYMOUTH
State: MN
PostalCode: 554464103
CountryCode: US
TelephoneNumber: 7632684084
FaxNumber: 7632684240
Practice Location
Address1: 2050 SOUTHGATE RD
Address2: STE 100
City: COLORADO SPRINGS
State: CO
PostalCode: 809062687
CountryCode: US
TelephoneNumber: 7195388488
FaxNumber: 7195388288
Other Information
ProviderEnumerationDate: 10/30/2009
LastUpdateDate: 10/30/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000XHAA200506COY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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