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PETER LAWRENCE CAMPBELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12721 DARBY BROOK CT, WOODBRIDGE, VA 22192-2408
(703) 492-9961
(703) 497-1225
Mailing address
PO BOX 2668, SPRINGFIELD, VA 22152-0668
(703) 492-9961
(703) 497-1225

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101029943
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000285424
ANTHEM BCBS
VA
05
007103921
VA
05
010145040
VA
01
016501T24
RR MEDICARE X
DC
01
1533
CAREFIRST BCBS/GHMSI
VA
01
15330001
MAGELLAN
VA
01
175105
BCBS VA
VA
01
2540172
AETNA
VA
01
521463549002
TRICARE
VA
01
60484701
BCBS MD
MD
01
915610
MDIPA/MAMSI
VA
01
G3960041
BCBS DC
DC
Enumeration date
08/11/2006
Last updated
05/01/2008
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