Healthcare Provider Details
I. General information
NPI: 1194724120
Provider Name (Legal Business Name): MICHAEL SEAN HOOKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/20/2005
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12200 WARWICK BLVD SUITE 310
NEWPORT NEWS VA
23601-2344
US
IV. Provider business mailing address
856 J CLYDE MORRIS BLVD STE A
NEWPORT NEWS VA
23601-1318
US
V. Phone/Fax
- Phone: 757-534-9988
- Fax: 757-534-5688
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 0101245435 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: