Provider Demographics
NPI:1043361835
Name:LASSETER, DAVID HOWELL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HOWELL
Last Name:LASSETER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 WILD DUCK CIR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-1244
Mailing Address - Country:US
Mailing Address - Phone:757-966-1221
Mailing Address - Fax:
Practice Address - Street 1:713 VOLVO PKWY STE 101
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1614
Practice Address - Country:US
Practice Address - Phone:757-609-3404
Practice Address - Fax:757-410-7215
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-054099207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890583JMedicaid
VA1043361835Medicaid
VA362903OtherANTHEM BC/BS (EVMS HEALTH SERVICES DIABETES INSTITUTE)
VAPAROtherMULTIPLAN (EVMS HEALTH SERVICES)
VAPAROtherVA PREMIER HEALTH (EVMS HEALTH SERVICES)
NC0583JOtherBC/BS
VA2997964OtherCIGNA (EVMS HEALTH SERVICES)
VA9631110OtherAETNA (EVMS HEALTH SERVICES)
VAPAROtherFIRST HEALTH COMMERCIAL (EVMS HEALTH SERVICES)
VA10040054OtherSENTARA/OPTIMA HEALTH (EVMS HEALTH SERVICES)
VA3196138OtherUNITED HEALTH CARE/MAMSI (EVMS HEALTH SERVICES)
VAPAROtherVIRGINIA HEALTH NETWORK (EVMS HEALTH SERVICES)
VAPAROtherUSA MANAGED CARE (EVMS HEALTH SERVICES)
VAPAROtherCORVEL/CORCARE (EVMS HEALTH SERVICES)
VA362893OtherANTHEM BC/BS (EVMS HEALTH SERVICES 600 GRESHAM DR.)
VA-033OtherTRICARE/CHAMPUS (EVMS HEALTH SERVICES)
VAPAROtherMULTIPLAN (EVMS HEALTH SERVICES)
VA1043361835Medicaid