Provider Demographics
NPI:1881793669
Name:VONU, PETER J (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:VONU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:895 CITY CENTER BLVD
Mailing Address - Street 2:SUITE #300
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3080
Mailing Address - Country:US
Mailing Address - Phone:757-873-3500
Mailing Address - Fax:757-591-5240
Practice Address - Street 1:895 CITY CENTER BLVD
Practice Address - Street 2:SUITE #300
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3080
Practice Address - Country:US
Practice Address - Phone:757-873-3500
Practice Address - Fax:757-591-5240
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-11-10
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Provider Licenses
StateLicense IDTaxonomies
VA0101042668208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6900330Medicaid
240000178Medicare PIN
C36725Medicare UPIN