Healthcare Provider Details

I. General information

NPI: 1770113482
Provider Name (Legal Business Name): YONATAN MOREH MD, ATP, EMT-P
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 07/30/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALEXANDER T. AUGUSTA MILITARY MEDICAL CENTER 9300 DEWITT LOOP
FORT BELVOIR VA
22060
US

IV. Provider business mailing address

ALEXANDER T. AUGUSTA MILITARY MEDICAL CENTER 9300 DEWITT LOOP
FORT BELVOIR VA
22060
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-0593
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35886
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: