Individual
KEVIN LAVENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
13347 WARWICK BLVD, NEWPORT NEWS, VA 23602-5601
(757) 877-0214
Mailing address
11761 ROCK LANDING DR STE 8, NEWPORT NEWS, VA 23606-4235
(757) 232-8769
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102206904
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2019
Last updated
07/28/2022
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