Provider Demographics
NPI:1578667853
Name:VANDEN HOEK, TODD L (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:L
Last Name:VANDEN HOEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4536 BONNEY RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3869
Mailing Address - Country:US
Mailing Address - Phone:757-490-9388
Mailing Address - Fax:757-490-9401
Practice Address - Street 1:736 BATTLEFIELD BLVD N
Practice Address - Street 2:CHESAPEAKE GENERAL HOSPITAL
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4941
Practice Address - Country:US
Practice Address - Phone:757-312-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046710207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
17320OtherOPTIMA
3900570OtherOPTIMUM CHOICE
VA6004547Medicaid
NC082480OtherBLUE CROSS BLUE SHIELD VA
251490OtherMAMSI/MDIPA
NC89065K2Medicaid
9300337797OtherMEDICARE RAILROAD
NC065K2OtherBLUE CROSS BLUE SHIELD NC
251490OtherMAMSI/MDIPA