NPI 1003058629

Peninsula Regional Medical Center

Organisation Family Medicine Physician Chincoteague, VA

Practice location

Address: 6295 Teal Ln Island Family Medicine, Chincoteague, VA 23336-2207
Phone: (757) 336-2200
Fax: (757) 336-2211
Mailing address: 100 E Carroll St, Salisbury, MD 21801

Authorised official

Name: Donna E Horner
Title: Credentialing Coordinator
Phone: (410) 543-7531

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Virginia →

Registry record

NPI: 1003058629
Entity type: Organization
NPI issued: 27 Mar 2009
Record last updated: 30 Apr 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.