NPI 1053670505

Andrew Lavergne, IDC

Practitioner Independent Duty Corpsman Virginia Beach, VA

Practice location

Address: 1900 Gator Blvd Bldg 3808, Virginia Beach, VA 23459-8950
Phone: (757) 763-2900

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1053670505
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 May 2012
Record last updated: 3 May 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.