Individual
STEPHANIE L PEGLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
100 EMANCIPATION DR, HAMPTON, VA 23667-1914
(757) 622-9961
Mailing address
100 EMANCIPATION DR, HAMPTON, VA 23667-2486
(757) 722-9961
(757) 722-9961
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0102203067
VA
2084P0802X
Addiction Psychiatry Physician
0102203067
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225354426
ANTHEM BEHAVIORAL HEALTH
VA
01
—
1225354426
MAGELLAN HEALTH CARE
—
05
—
1225354426
—
VA
Enumeration date
04/13/2010
Last updated
05/26/2021
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