Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 541749837 | VA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 541749837 | VA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 541749837 | VA |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 541749837 | VA |
N | 2082S0105X | Plastic Hand Surgeon | 541749837 | VA |
N | 2086S0105X | Surgery of the Hand | 541749837 | VA |
NPI | 1962519595 |
---|---|
Provider Name | Dr. Stephen Jacob Leibovic |
First Address | Richmond, VA 23294-4425 |
Second Address | Richmond, VA 23294-4425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 19/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
028179 | HAND SURGERY (01) | VA |
3009495 | HAND SURGERY (01) | VA |
321434 | HAND SURGERY (01) | VA |
541749837 | HAND SURGERY (01) | VA |
E53302 | (02) | VA |