Provider Demographics
NPI:1932145349
Name:PETER GUHL PLC
Entity Type:Organization
Organization Name:PETER GUHL PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:L
Authorized Official - Last Name:GUHL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-890-2020
Mailing Address - Street 1:4102 GEORGE WASHINGTON MEM HWY
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2885
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:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-2885
Practice Address - Country:US
Practice Address - Phone:757-890-2020
Practice Address - Fax:757-890-9125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000215152WC0802X, 152WL0500X, 152WV0400X, 2084P0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental DisabilitiesGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0004493249OtherAETNA
VA382104OtherHIGHMARK BC/BS
VA13020OtherMEDIPLUS
VA0505840001OtherADMIN FEDERAL
VA335862MD2OtherMDIPA
VA009206655Medicaid
VA55830OtherSENTARA
VA1953721OtherCIGNA
VA251377OtherANTHEM
VA009206655Medicaid