Provider Demographics
NPI:1730156563
Name:HAMMELL, ABRAHAM JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:JOSEPH
Last Name:HAMMELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 S MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55921-1331
Mailing Address - Country:US
Mailing Address - Phone:630-679-5879
Mailing Address - Fax:507-724-1213
Practice Address - Street 1:424 S MARSHALL ST
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MN
Practice Address - Zip Code:55921-1331
Practice Address - Country:US
Practice Address - Phone:630-679-5879
Practice Address - Fax:507-724-1213
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001875208D00000X
MN50512208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice