Provider Demographics
NPI:1669161717
Name:HAMMELL, CARLY ANN (MD)
Entity type:Individual
Prefix:MS
First Name:CARLY
Middle Name:ANN
Last Name:HAMMELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 MAIN STREET
Mailing Address - Street 2:FLOOR 3
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199
Mailing Address - Country:US
Mailing Address - Phone:413-794-1591
Mailing Address - Fax:
Practice Address - Street 1:759 CHESTNUT STREET
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01199
Practice Address - Country:US
Practice Address - Phone:413-794-4326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2024-01-05
Deactivation Date:2023-12-07
Deactivation Code:
Reactivation Date:2024-01-05
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program