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Individual

DR. SIMON P PENNINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
613 CAMPUS DR, SUITE 200, ABINGDON, VA 24210-9703
(276) 628-1186
(276) 628-8507
Mailing address
613 CAMPUS DR, SUITE 200, ABINGDON, VA 24210-9703
(276) 628-1186
(276) 628-8507

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101034401
VA
207Q00000X
Family Medicine Physician
Primary
0101034401
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02
JD
01
064411
ANTHEM
05
1316936131
VA
01
3054602
BLUE CLASSIC
01
43304
OPTIMA SENTARA
01
4583916
AETNA
05
5642507
VA
Enumeration date
10/14/2005
Last updated
10/24/2024
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