Provider Demographics
NPI:1588639850
Name:ACKERMAN, STEVEN B (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:ACKERMAN
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 1:850 KEMPSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502
Mailing Address - Country:US
Mailing Address - Phone:757-261-5840
Mailing Address - Fax:757-261-5861
Practice Address - Street 1:830 KEMPSVILLE RD
Practice Address - Street 2:SENTARA LEIGH HOSPITAL
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-261-5840
Practice Address - Fax:757-261-5861
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046911207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006041744Medicaid
110005706Medicare ID - Type Unspecified
F55607Medicare UPIN