Provider Demographics
NPI:1942237805
Name:LEVERONE, LAURA ISENHOUR (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ISENHOUR
Last Name:LEVERONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 HILLPOINT BLVD N
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8470
Mailing Address - Country:US
Mailing Address - Phone:757-668-2250
Mailing Address - Fax:757-668-2255
Practice Address - Street 1:1009 HILLPOINT BLVD N
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8470
Practice Address - Country:US
Practice Address - Phone:757-668-2250
Practice Address - Fax:757-668-2255
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101053635208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541778786OtherUNITED HEALTH CARE
VA878410OtherMAMSI/MDIPA
VA541778786OtherVIRGINIA HEALTH NETWORK
VA00676037Medicaid
VA228113OtherANTHEM
VA54556OtherOPTIMA
VA5018473OtherAETNA
NC790558TMedicaid
VA541778786023OtherTRICARE
VA541778786663OtherCIGNA
VA00676037Medicaid