Healthcare Provider Details

I. General information

NPI: 1881793669
Provider Name (Legal Business Name): PETER J VONU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 CITY CENTER BLVD SUITE #300
NEWPORT NEWS VA
23606-3080
US

IV. Provider business mailing address

895 CITY CENTER BLVD SUITE #300
NEWPORT NEWS VA
23606-3080
US

V. Phone/Fax

Practice location:
  • Phone: 757-873-3500
  • Fax: 757-591-5240
Mailing address:
  • Phone: 757-873-3500
  • Fax: 757-591-5240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number0101042668
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: