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General NPI Number Information
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NPI Number | 1245211911
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Entity Type | Individual
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Provider Name | ANTHONY PELLEGRINO MD
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Gender | Male
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 300 MEDICAL PKWY STE 314
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4985
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Country | US
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Telephone | 757-312-6195
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Fax | 757-937-0998
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Provider Business Mailing Address
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Address Line | 667 KINGSBOROUGH SQ STE 101
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4999
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Country | US
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Telephone | 757-842-4481
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Fax | 757-312-3135
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 02618
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 0101265619
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25352
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License Number State | AZ
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