Individual
DR. CHARLES HECHT-LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4668 PEMBROKE BLVD, SUITE 117, VIRGINIA BEACH, VA 23455-6423
(757) 671-1144
(767) 671-1265
Mailing address
4668 PEMBROKE BLVD, SUITE 117, VIRGINIA BEACH, VA 23455-6423
(757) 671-1144
(767) 671-1265
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101041588
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007223251
VIRGINIA PREMIER
VA
05
—
007223251
—
VA
01
—
300013597
RAILROAD MEDICARE
VA
01
—
8906568
NORTH CAROLINA MEDICAID
VA
Enumeration date
11/29/2005
Last updated
04/22/2008
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