Organization
E HAQUE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ETHESHAMUL HAQUE MD (PRESIDENT)
(757) 489-3911
Entity
Organization
Contact information
Practice address
110 KINGSLEY LN, SUITE 209, NORFOLK, VA 23505-4614
(757) 489-3911
Mailing address
1443 N VEAUX LOOP, NORFOLK, VA 23509-1259
(757) 627-4333
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101231617
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5862345
—
VA
Enumeration date
01/02/2007
Last updated
08/22/2020
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