Provider Demographics
NPI:1285739649
Name:HANMER, ALFRED W (MD)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:W
Last Name:HANMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:SUITE 341
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462
Mailing Address - Country:US
Mailing Address - Phone:617-964-0024
Mailing Address - Fax:617-964-6374
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:SUITE 341
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462
Practice Address - Country:US
Practice Address - Phone:617-964-0024
Practice Address - Fax:617-964-6374
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA54775207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA054775OtherTUFTS
MA17368OtherHARVARD PILGRIM
MA3000214Medicaid
MAB20023601OtherCIGNA
MAJ04945OtherBLUE CROSS BLUE SHIELD
MAA58140Medicare UPIN
MAB20023601OtherCIGNA