Provider Demographics
NPI:1841610680
Name:HAWKINS, MICHAEL PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PHILIP
Last Name:HAWKINS
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:STONY BROOK UNIVERSITY HOSPITAL
Mailing Address - Street 2:MEDICAL/HOUSE STAFF SERVICES DEPT T9-110
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-7097
Mailing Address - Country:US
Mailing Address - Phone:631-444-8413
Mailing Address - Fax:631-706-3002
Practice Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL
Practice Address - Street 2:MEDICAL/HOUSE STAFF SERVICES DEPT T9-110
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-7097
Practice Address - Country:US
Practice Address - Phone:631-444-8413
Practice Address - Fax:631-706-3002
Is Sole Proprietor?:No
Enumeration Date:2014-04-20
Last Update Date:2014-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12696795390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program