Healthcare Provider Details

I. General information

NPI: 1871684563
Provider Name (Legal Business Name): HAMPTON ROADS GASTROENTEROLOGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 10/03/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 BUTLER FARM ROAD, SUITE 103
HAMPTON VA
23666
US

IV. Provider business mailing address

303 BUTLER FARM ROAD, SUITE 103
HAMPTON VA
23666
US

V. Phone/Fax

Practice location:
  • Phone: 757-826-7785
  • Fax: 757-826-9028
Mailing address:
  • Phone: 757-826-7785
  • Fax: 757-826-9028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: HASSAN ADNAN HASSAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 757-826-7785