Provider Demographics
NPI:1174687750
Name:CAJULIS, LEONARD R (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:R
Last Name:CAJULIS
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 1:1060 FIRST COLONIAL RD
Mailing Address - Street 2:1ST FL
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3002
Mailing Address - Country:US
Mailing Address - Phone:757-507-4111
Mailing Address - Fax:757-685-2100
Practice Address - Street 1:1060 FIRST COLONIAL RD
Practice Address - Street 2:1ST FL
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3002
Practice Address - Country:US
Practice Address - Phone:757-507-4111
Practice Address - Fax:757-685-2100
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010181500Medicaid
VA006487F15Medicare ID - Type Unspecified
VA010181500Medicaid