Provider Demographics
NPI:1437137742
Name:HACKER, ANKE (MD)
Entity Type:Individual
Prefix:
First Name:ANKE
Middle Name:
Last Name:HACKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 CENTERBROOKE LANE
Mailing Address - Street 2:PMB 412 SUITE F
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434
Mailing Address - Country:US
Mailing Address - Phone:757-337-4018
Mailing Address - Fax:757-337-4019
Practice Address - Street 1:5849 HARBOUR VIEW BLVD STE 250
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3769
Practice Address - Country:US
Practice Address - Phone:757-337-4018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237295207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA-002 -003 -028OtherTRICARE/CHAMPUS
VA289907OtherANTHEM PFM
NC5905949Medicaid
VAPAROtherUSA MANAGED CARE
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA2180414OtherUHC/MAMSI
NC05949OtherNC BC BS
VA1437137742Medicaid
VA10018878OtherSENTARA/OPTIMA
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherVA HEALTH NETWORK
VAPAROtherAETNA
VA289897OtherANTHEM/GHENT
VA3162622OtherUHC/MAMSI (INTERNAL MEDICINE)
VAPAROtherCORVEL/CORCARE
VAPAROtherCIGNA
VAPAROtherMULTIPLAN
VA10018878OtherSENTARA/OPTIMA
VA2180414OtherUHC/MAMSI
VA289897OtherANTHEM/GHENT