Provider Demographics
NPI:1932651585
Name:EBINGER, PEGGY (MD)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:EBINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 CORPORATION LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3162
Mailing Address - Country:US
Mailing Address - Phone:757-552-8974
Mailing Address - Fax:757-552-7108
Practice Address - Street 1:4417 CORPORATION LN
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3162
Practice Address - Country:US
Practice Address - Phone:757-552-8974
Practice Address - Fax:757-552-7108
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010500492084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry