Individual
LESLIE WALTERS FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 E BROAD ST, RICHMOND, VA 23219-1930
(804) 828-6703
(804) 527-4728
Mailing address
PO BOX 980257, RICHMOND, VA 23298-0257
(804) 828-9783
(804) 828-5613
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101274580
VA
2080P0205X
Pediatric Endocrinology Physician
Primary
0101274580
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
04/26/2019
Last updated
06/29/2024
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