National Provider Identifier Database

PENINSULA CANCER INSTITUTE LLC
Hematology & Oncology

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.


Contact Information

PENINSULA CANCER INSTITUTE, LLC
12100 WARWICK BLVD.
SUITE 201
NEWPORT NEWS, VA23601-2365
Phone: 757-534-5555
Fax: 757-534-5569
Website:
Specialty Taxonomy Code
* Hematology & Oncology 207RH0003X
Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for PENINSULA CANCER INSTITUTE, LLC

NPI Number 1508947342
Legal business name
LBN
PENINSULA CANCER INSTITUTE, LLC
Authorized official BRADEN MILLER - (CFO)
Entity Organization
Organization subpart No
Enumeration date 10/18/2006
Last updated 04/28/2026 - About a month ago
Sole proprietor1 Not specified
Identifiers
  • VA License #: 0101043974
  • VA Medicaid: 0101047727
  • VA Medicaid: 010125626
  • VA Medicaid: 010162338
  • VA Medicaid: 010202761
  • VA Medicaid: 010228484

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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