Provider Demographics
NPI:1811335011
Name:MOSKAL, PETER T (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:T
Last Name:MOSKAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 KEMPSVILLE ROAD, BLDG. A
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502
Mailing Address - Country:US
Mailing Address - Phone:757-668-6550
Mailing Address - Fax:757-668-6544
Practice Address - Street 1:171 KEMPSVILLE RD STE 201
Practice Address - Street 2:BLDG A SUITE 201
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502
Practice Address - Country:US
Practice Address - Phone:757-668-6550
Practice Address - Fax:757-668-6544
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101270019207XP3100X
NC191415390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program