Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Peninsula Cosmetic & Reconstructive Surgery Inc

Organization Plastic Surgery Physician · NPI 1720398761

Peninsula Cosmetic & Reconstructive Surgery Inc provides Plastic Surgery Physician services in Hampton, Virginia. Licensed in Virginia. Registered with an NPI since 2010.

Licensed in
VA
In the registry since
2010
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4000 Coliseum Dr Ste 110
Hampton, VA 23666-5906 Not confirmed with CMS for 15 years — call before visiting
Phone: (757) 827-8486
Fax: (757) 827-8718
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence 0101041391 (VA)

Record details

NPI number1720398761
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Kanter — Owner/ Doctor · (757) 827-8486
NPI enumeratedOctober 8, 2010
Last updated in NPPESOctober 8, 2010
Mailing address4000 Coliseum Dr, Suite 110, Hampton, VA 23666-5906