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General NPI Number Information
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NPI Number | 1053358143
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Entity Type | Individual
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Provider Name | PETER J RECUPERO D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 3700 S MAIN ST
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City | BLACKSBURG
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State | VA
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Zip | 24060-7017
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Country | US
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Telephone | 540-951-1111
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Fax | 540-953-5158
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Provider Business Mailing Address
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Address Line | 2000 HEALTH PARK DR FL HP2
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City | BRENTWOOD
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State | TN
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Zip | 37027-4692
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Country | US
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Telephone | 615-373-7600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OS9238
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0102202542
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0102202542
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License Number State | VA
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