Healthcare Provider Details

I. General information

NPI: 1750587036
Provider Name (Legal Business Name): JOHN A ENGLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4207 LAKE BOONE TRL STE 220
RALEIGH NC
27607-6685
US

IV. Provider business mailing address

620 JOHN PAUL JONES CIRCLE NAVAL MEDICAL CENTER PORTSMOUTH
PORTSMOUTH VA
23708
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-1410
  • Fax:
Mailing address:
  • Phone: 757-953-9390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number0101258885
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number2018-01242
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: