Individual
DR. EHTESHAMUL HAQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1443 N VEAUX LOOP, NORFOLK, VA 23509-1259
(757) 627-3898
(757) 627-0054
Mailing address
1443 NORTH VEAUX LOOP, NORFOLK, VA 23509-1259
(757) 627-3898
(757) 627-0054
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101231617
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
461932
ANTHEM BC
—
01
—
58013
SENTARA OPTIMA
—
05
—
5862345
—
VA
Enumeration date
01/27/2006
Last updated
01/12/2008
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