MEDICARE: MARGUERITE SLINGLUFF LENGKEEK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	0101230854	VA
2	207K00000X	Allergy & Immunology Physician	C54738	CA
3	207K00000X	Allergy & Immunology Physician	0101230854	VA
4	208000000X	Pediatrics Physician	C54738	CA

General Provider Information

NPI Number	:	1043290646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGUERITE SLINGLUFF LENGKEEK M.D.

Provider Business Mailing Address
First Line	:	1704 SIR WILLIAM OSLER DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3003
Country	:	US
Telephone Number	:	757-481-4383
Fax Number	:	757-481-4611

Provider Business Practice Location Address
First Line	:	1704 SIR WILLIAM OSLER DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3003
Country	:	US
Telephone Number	:	202-680-4106
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	10/20/2016

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