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General NPI Number Information
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NPI Number | 1932202306
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Entity Type | Individual
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Provider Name | LEONID STEPANOV DO
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 800 INDEPENDENCE BLVD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455
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Country | US
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Telephone | 757-965-4759
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Fax | 757-466-6970
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Provider Business Mailing Address
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Address Line | 5555 GREENWICH RD SUITE 501
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462
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Country | US
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Telephone | 757-687-1133
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Fax | 757-687-1343
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0102201889
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License Number State | VA
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