Healthcare Provider Details

I. General information

NPI: 1801041629
Provider Name (Legal Business Name): SEAN E. HESSELBACHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 KEMPSVILLE RD STE 100G
NORFOLK VA
23502-3920
US

IV. Provider business mailing address

850 KEMPSVILLE RD STE 100G
NORFOLK VA
23502-3920
US

V. Phone/Fax

Practice location:
  • Phone: 757-261-5977
  • Fax: 757-275-9913
Mailing address:
  • Phone: 757-261-5977
  • Fax: 757-275-9913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberBP10029260
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0101250532
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number0101250532
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0101250532
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: