Healthcare Provider Details

I. General information

NPI: 1710628599
Provider Name (Legal Business Name): EMILY PETERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 FAIRFAX AVE #544
NORFOLK VA
23507
US

IV. Provider business mailing address

825 FAIRFAX AVE #544
NORFOLK VA
23507
US

V. Phone/Fax

Practice location:
  • Phone: 757-446-7900
  • Fax:
Mailing address:
  • Phone: 757-446-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101290138
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: