Individual
LAGORA A. OLIVER BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2301 GENERAL BOOTH BLVD, STE B, VIRGINIA BEACH, VA 23456-7755
(757) 963-5500
(757) 275-9907
Mailing address
2301 GENERAL BOOTH BLVD, STE B, VIRGINIA BEACH, VA 23456-7755
(757) 963-5500
(757) 275-9907
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101234783
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010090865
—
VA
Enumeration date
09/20/2005
Last updated
04/11/2014
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