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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 Specialty Code Provider Type

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for PENINSULA CANCER INSTITUTE, LLC

NPI # 1508947342
LBN Legal business name PENINSULA CANCER INSTITUTE, LLC
Authorized official BRADEN MILLER - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 10/18/2006
Last updated 04/28/2026 - About a month ago
Identifiers
VA License # 0101043974
VA Medicaid 0101047727
VA Medicaid 010125626
VA Medicaid 010162338
VA Medicaid 010202761
VA Medicaid 010228484
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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