Organization
MICHAEL A. LEPORE, JR., M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A. LEPORE, JR. M.D. (PRESIDENT)
(757) 686-8700
Entity
Organization
Contact information
Practice address
1510 BREEZEPORT WAY STE 600, HARBOUR BREEZE PROFESSIONAL CENTER, SUFFOLK, VA 23435-3738
(757) 686-8700
(757) 686-8006
Mailing address
1510 BREEZEPORT WAY STE 600, HARBOUR BREEZE PROFESSIONAL CENTER, SUFFOLK, VA 23435-3738
(757) 686-8700
(757) 686-8006
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006209181
—
VA
01
—
160058189
RAILROAD MEDICARE
VA
01
—
49D0863102
CLIA NUMBER
VA
05
—
5901723
—
NC
Enumeration date
01/16/2007
Last updated
10/20/2014
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