Healthcare Provider Details

I. General information

NPI: 1770652646
Provider Name (Legal Business Name): PEDIATRIC PARTNERS OF HAMPTON ROADS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 10/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

656 INDEPENDENCE PARKWAY SUITE 200
CHESAPEAKE VA
23320
US

IV. Provider business mailing address

656 INDEPENDENCE PARKWAY SUITE 200
CHESAPEAKE VA
23320
US

V. Phone/Fax

Practice location:
  • Phone: 757-410-3630
  • Fax: 757-410-3630
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: VERNITA NEWBY PEEPLES
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 757-410-3630