Basic Information
Provider Information
NPI: 1093785974
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOOK
FirstName: MATTHEW
MiddleName: ALAN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3000 NEW BERN AVE
Address2: SUITE G-100
City: RALEIGH
State: NC
PostalCode: 276101231
CountryCode: US
TelephoneNumber: 9192318253
FaxNumber: 9192318253
Practice Location
Address1: 3000 NEW BERN AVE
Address2: SUITE G-100
City: RALEIGH
State: NC
PostalCode: 276101231
CountryCode: US
TelephoneNumber: 9192318253
FaxNumber: 9192318253
Other Information
ProviderEnumerationDate: 01/24/2006
LastUpdateDate: 04/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X2006-01266NCN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000X2006-01266NCN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RI0011X2006-01266NCY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

ID Information
IDTypeStateIssuerDescription
590435205NC MEDICAID


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