Provider Demographics
NPI:1619986262
Name:HINNANT, LEE COLEMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:COLEMAN
Last Name:HINNANT
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 1:828 HEALTHY WAY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7958
Mailing Address - Country:US
Mailing Address - Phone:757-305-1797
Mailing Address - Fax:757-309-4715
Practice Address - Street 1:828 HEALTHY WAY
Practice Address - Street 2:SUITE 220
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7958
Practice Address - Country:US
Practice Address - Phone:757-305-1797
Practice Address - Fax:757-309-4715
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238935207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00665307Medicare PIN
VA016435B09Medicare PIN