Healthcare Provider Details

I. General information

NPI: 1932189644
Provider Name (Legal Business Name): WILLIAM N HOVLAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 KINGSLEY LN STE 106
NORFOLK VA
23505-4614
US

IV. Provider business mailing address

110 KINGSLEY LN STE 106
NORFOLK VA
23505-4614
US

V. Phone/Fax

Practice location:
  • Phone: 757-889-5735
  • Fax: 757-889-5742
Mailing address:
  • Phone: 757-889-5735
  • Fax: 757-889-5742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101026403
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number0101026403
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: