Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0101230854 | VA |
N | 207K00000X | Allergist & Immunologist | C54738 | CA |
N | 208000000X | Pediatrician | 0101230854 | VA |
N | 208000000X | Pediatrician | C54738 | CA |
NPI | 1043290646 |
---|---|
Provider Name | Marguerite Slingluff Lengkeek |
First Address | Virginia Beach, VA 23454-3003 |
Second Address | Virginia Beach, VA 23454-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 20/10/2016 |