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General NPI Number Information
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NPI Number | 1003711979
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Entity Type | Organization
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Legal Business Name | PEKO-HAMPTON ROADS LLC
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Dates
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Enumeration Date | 10/12/2026
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Last Update Date | 10/21/2026
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Provider Practice Location Address
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Address Line | 1868 WILDWOOD DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3124
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Country | US
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Telephone | 567-408-7356
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Fax |
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Provider Business Mailing Address
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Address Line | 1868 WILDWOOD DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3124
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Country | US
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Telephone | 567-408-7356
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARTIN CARNEY III
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Credential | MD
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Telephone | 567-408-7356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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