Provider Demographics
NPI:1538109392
Name:GUHL, PETER L (OD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:L
Last Name:GUHL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4102 GEORGE WASHINGTON MEM HWY
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2725
Mailing Address - Country:US
Mailing Address - Phone:757-890-2020
Mailing Address - Fax:757-890-9125
Practice Address - Street 1:4102 GEORGE WASHINGTON MEM HWY
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:VA
Practice Address - Zip Code:23692-2725
Practice Address - Country:US
Practice Address - Phone:757-890-2020
Practice Address - Fax:757-890-9125
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000215152WC0802X, 152WL0500X, 152WV0400X, 2084P0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA13020OtherMEDIPLUS
VA335862MD2OtherMDIPA
VAP00118845OtherMEDICARE-RAILROAD
VA251377OtherANTHEM BC/BS
VA1953721OtherCIGNA
VA065709OtherDEPT OF REHAB
VA382104OtherHIGHMARK BC/BS
VA0004493249OtherAETNA
VA009206655Medicaid
VA382104OtherHIGHMARK BC/BS
VA251377OtherANTHEM BC/BS