Provider Demographics
NPI:1801943782
Name:HOOPER, MICHAEL H (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:HOOPER
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:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-5758
Mailing Address - Fax:757-446-7452
Practice Address - Street 1:855 W BRAMBLETON AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1005
Practice Address - Country:US
Practice Address - Phone:757-446-5758
Practice Address - Fax:757-446-7452
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249436207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5917424Medicaid
VAPAROtherCORVEL
VA427480OtherANTHEM BC/BS
VAPAROtherCIGNA
VAPAROtherVIRGINIA HEALTH NETWORK
VA1801943782Medicaid
VA10076429OtherOPTIMA HEALTH
VAPAROtherUSA MANAGED CARE
VA-029OtherTRICARE/CHAMPUS
VA1801943782OtherVIRGINIA PREMIER HEALTH PLAN
VAPAROtherAETNA
VAVV2168AMedicare PIN
VA1801943782OtherFIRST HEALTH NETWORK/COVENTRY HEALTH
VAPAROtherMULTIPLAN
VA1801943782OtherUNITED HEALTHCARE/MAMSI
VAP00964292Medicare PIN