Peninsula Surgical Associates, Inc.

NPI #1720159270 in Hampton, Virginia

Provider Information

NPI Number: 1720159270
Entity Type: Organization
Organization Name: Peninsula Surgical Associates, Inc.
Primary Specialty: Specialist
Enumeration Date: Nov 13, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 4000 COLISEUM DR
Address 2: SUITE 200
City: Hampton
State: Virginia
ZIP Code: 23666-5906
Phone: (757) 827-2040

Authorized Official

Name: DR. DAVID LEON GORE JR., M.D.
Title: PRESIDENT
Phone: (757) 827-2040

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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