MEDICARE: JOHN R WARKENTIN M.D.

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
1	207RP1001X	Pulmonary Disease Physician	0101026633	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	290003786	OTHER	VA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4800049	OTHER	VA	UNITED HEALTHCARE PROV #
2	00689540	OTHER	VA	BLACK LUNG PROVIDER NUMBE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	32078	OTHER	VA	CARENET PROVIDER NUMBER
6	7101413	OTHER	VA	MAMSI PROVIDER NUMBER
7	021804	OTHER	VA	CIGNA
8	557515	OTHER	VA	AETNA PROVIDER NUMBER
9	59216	OTHER	VA	SOUTHERN HEALTH PROV #
10	083626	OTHER	VA	ANTHEM PROVIDER NUMBER

General Provider Information

NPI Number	:	1326064163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN R WARKENTIN M.D.

Provider Business Mailing Address
First Line	:	1000 BOULDERS PKWY
Second Line	:	SUITE 102
City	:	RICHMOND
State	:	VA
Zip	:	23225-5545
Country	:	US
Telephone Number	:	804-320-4243
Fax Number	:	804-282-1486

Provider Business Practice Location Address
First Line	:	1603 SANTA ROSA RD
Second Line	:	SUITE 101
City	:	RICHMOND
State	:	VA
Zip	:	23229-5010
Country	:	US
Telephone Number	:	804-320-4243
Fax Number	:	804-622-0552

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	11/14/2013

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Directions to “ JOHN R WARKENTIN M.D.” Practice Location

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