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Organization

MARK J KANTER MD PC

Active
Other names
Peninsula Cosmetic & Reconstructive Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK J KANTER MD (OWNER PRESISDENT PHYSICIAN)
(757) 827-8486
Entity
Organization

Contact information

Practice address
4000 COLISEUM DR, SUITE 110, HAMPTON, VA 23666-5906
(757) 827-8486
(757) 827-8718
Mailing address
4000 COLISEUM DR, SUITE 110, HAMPTON, VA 23666-5906
(757) 827-8486
(757) 827-8718

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0101041391
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
143014
ANTHEM AMBULATORY SURGERY
VA
01
143018
ANTHEM AMBULATORY SURGERY
VA
Enumeration date
10/18/2006
Last updated
07/24/2008
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