Provider Demographics
NPI:1346378825
Name:HAMMOND, CYNTHIA CECELIA (OD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:CECELIA
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47626 CHERYL CT
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-4708
Mailing Address - Country:US
Mailing Address - Phone:586-996-0903
Mailing Address - Fax:586-254-2129
Practice Address - Street 1:14300 LAKESIDE CIR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1326
Practice Address - Country:US
Practice Address - Phone:586-996-0903
Practice Address - Fax:586-322-3523
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2812152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist