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NPI Code Detail

MEDICARE: DOROTHY REQUINA MD

MEDICARE: DOROTHY REQUINA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician0101279443VA

General Provider Information

NPI Number : 1154071009
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOROTHY REQUINA MD
Provider Business Mailing Address
First Line : 620 JOHN PAUL JONES CIR
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23708-2111
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 620 JOHN PAUL JONES CIR
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23708-2111
Country : US
Telephone Number : 757-953-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2022
Last Update Date : 06/30/2026

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Directions to “ DOROTHY REQUINA MD” Practice Location

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