MEDICARE: PETER L GUHL O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	0618000215	VA
2	152WL0500X	Low Vision Rehabilitation Optometrist	0618000215	VA
3	152WV0400X	Vision Therapy Optometrist	0618000215	VA
4	2084P0005X	Neurodevelopmental Disabilities Physician	0618000215	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00118845	OTHER	VA	MEDICARE-RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13020	OTHER	VA	MEDIPLUS
2	335862MD2	OTHER	VA	MDIPA
4	251377	OTHER	VA	ANTHEM BC/BS
5	1953721	OTHER	VA	CIGNA
6	065709	OTHER	VA	DEPT OF REHAB
7	382104	OTHER	VA	HIGHMARK BC/BS
8	0004493249	OTHER	VA	AETNA
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538109392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER L GUHL O.D.

Provider Business Mailing Address
First Line	:	4102 GEORGE WASHINGTON MEM HWY
Second Line	:
City	:	GRAFTON
State	:	VA
Zip	:	23692-2725
Country	:	US
Telephone Number	:	757-890-2020
Fax Number	:	757-890-9125

Provider Business Practice Location Address
First Line	:	4102 GEORGE WASHINGTON MEM HWY
Second Line	:
City	:	GRAFTON
State	:	VA
Zip	:	23692-2725
Country	:	US
Telephone Number	:	757-890-2020
Fax Number	:	757-890-9125

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	04/26/2016

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Directions to “ PETER L GUHL O.D.” Practice Location

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