PENINSULA CANCER INSTITUTE, LLC – NPI #1508947342
Internal Medicine

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Health Care Provider Taxonomy Code for Internal Medicine

PENINSULA CANCER INSTITUTE, LLC is a provider located in NEWPORT NEWS, VA. NPPES has assigned the NPI number 1508947342 to PENINSULA CANCER INSTITUTE, LLC on October 18, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. According to the NPI Registry, there are 2 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RH0003X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Hematology & Oncology

The NPI profile was last updated on Apr 28, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PENINSULA CANCER INSTITUTE, LLC below.

NPI Profile for
PENINSULA CANCER INSTITUTE, LLC

NPI Number
1508947342
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PENINSULA CANCER INSTITUTE, LLC
Primary location
12100 WARWICK BLVD.
SUITE 201
NEWPORT NEWS, VA 23601-2365
Phone: (757) 534-5555 Fax: (757) 534-5569
2 Other location(s):
7544 Medical Dr Ste B-1
Gloucester, VA 23061-4299
Phone: (804) 693-9037
Fax: (804) 693-9486
120 Kings Way Ste 3100-A
Williamsburg, VA 23185-2505
Phone: (757) 345-5724
Fax: (757) 345-2236
Mailing address
856 J CLYDE MORRIS BLVD STE A
NEWPORT NEWS, VA 23601-1318
Phone: (757) 594-4006 Fax: (757) 534-5190
Organization Subpart
No
Authorized Official
BRADEN MILLER
CFO
Phone: (757) 594-4006
Updated
Certification Date
Apr 28, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for PENINSULA CANCER INSTITUTE, LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

See identifiers
DescriptionIssuerStateIdentifier
medicaidVA010162338
medicaidVA010125626
medicaidVA010202761
medicaidVA0101047727
medicaidVA010228484
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RH0003X
- Internal Medicine / Hematology & Oncology (Primary)
174400000X
- Specialist		 VA 0101043974

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.