Provider Demographics
NPI:1942288667
Name:HAWKES, DAVID (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:HAWKES
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 1:500 GILLUMS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-7629
Mailing Address - Country:US
Mailing Address - Phone:434-979-2076
Mailing Address - Fax:
Practice Address - Street 1:2411 IVY RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4971
Practice Address - Country:US
Practice Address - Phone:434-296-8300
Practice Address - Fax:434-296-1036
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038148208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010717OtherCIGNA
VA12062200001OtherSOUTHERN HEALTH
VA333843OtherANTHEM
VA42723OtherVETRI
VA267025OtherMAMSI/ALLIANCE