Provider Demographics
NPI:1760445647
Name:PEREGRINO, MANUEL ANGEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:ANGEL
Last Name:PEREGRINO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:102 HIGHLAND AVE SE
Mailing Address - Street 2:CARILION ROANOKE COMMUNITY HOSPITAL NICU
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24013-2256
Mailing Address - Country:US
Mailing Address - Phone:540-985-9840
Mailing Address - Fax:
Practice Address - Street 1:102 HIGHLAND AVE SE
Practice Address - Street 2:CARILION ROANOKE COMMUNITY HOSPITAL NICU
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24013-2256
Practice Address - Country:US
Practice Address - Phone:540-985-9840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012363692080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine