Organization
PENINSULA CANCER INSTITUTE LLC
Active
Parent organization
RIVERSIDE HEALTHCARE ASSOCIATES
Other names
Shore Cancer Institute
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERSIDE HEALTHCARE ASSOCIATES
Authorized official
BRADEN MILLER (CFO)
(757) 316-5800
Entity
Organization
Contact information
Practice address
20480 MARKET STREET, ONANCOCK, VA 23417
(757) 302-2600
Mailing address
856 J CLYDE MORRIS BLVD, STE A, NEWPORT NEWS, VA 23601-1318
(757) 316-5960
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Enumeration date
01/15/2010
Last updated
02/09/2017
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