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Individual

DR. STEVEN MICHAEL LADERBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
5308 PROVIDENCE RD, VIRGINIA BEACH, VA 23464-4102
(757) 499-2020
Mailing address
5254 JACOB CT, VIRGINIA BEACH, VA 23464-2518
(757) 499-2020

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000078
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009203699
VA
Enumeration date
09/26/2005
Last updated
01/14/2010
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