National Provider Identifier Database

PENINSULA PLASTIC SURGERY CENTER
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.


Contact Information

PENINSULA PLASTIC SURGERY CENTER
324 MONTICELLO AVE
WILLIAMSBURG, VA23185-2834
Phone: 757-229-5200
Fax: 757-229-2692
Website:
Specialty Taxonomy Code
* General Practice 208D00000X
Plastic Surgery 208200000X
Specialist 174400000X
Surgery of the Hand 2082S0105X

* Indicates primary specialty

NPI Profile & details for PENINSULA PLASTIC SURGERY CENTER

NPI Number 1689731986
Legal business name
LBN
PENINSULA PLASTIC SURGERY CENTER
Authorized official JOHN PITMAN - (PHYSICIAN)
Entity Organization
Organization subpart No
Enumeration date 01/03/2007
Last updated 12/11/2020 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • VA License #: 0101052484
  • VA Medicaid: 007601328
  • VA Other: 5209080 AETNA
  • VA Other: 140457 ANTHEM
  • VA Other: 213427 CIGNA
  • VA Other: 620043172 RAILROAD MEDICARE
  • VA Other: 54536 SENTARA OPTIMA
  • VA Other: 121242 SOUTHERN HEALTH
  • VA Other: 432612 UNITED HEALTHCARE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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