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General NPI Number Information
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NPI Number | 1124055470
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR CENTER OF HAMPTON ROADS
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11803 JEFFERSON AVE SUITE 110
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2565
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Country | US
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Telephone | 757-873-0360
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Fax | 757-873-0847
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Provider Business Mailing Address
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Address Line | 11803 JEFFERSON AVE SUITE 110
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2565
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Country | US
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Telephone | 757-873-0360
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Fax | 757-873-0847
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HUGH B MCCORMICK JR.
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Credential | M.D.
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Telephone | 757-873-0360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 635042
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License Number State | VA
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