MEDICARE: DR. JOHN A ENGLER 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	171000000X	Military Health Care Provider	0101258885	VA
2	207T00000X	Neurological Surgery Physician	2018-01242	NC

General Provider Information

NPI Number	:	1750587036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN A ENGLER M.D.

Provider Business Mailing Address
First Line	:	620 JOHN PAUL JONES CIRCLE
Second Line	:	NAVAL MEDICAL CENTER PORTSMOUTH
City	:	PORTSMOUTH
State	:	VA
Zip	:	23708
Country	:	US
Telephone Number	:	757-953-9390
Fax Number	:

Provider Business Practice Location Address
First Line	:	4207 LAKE BOONE TRL STE 220
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-6685
Country	:	US
Telephone Number	:	919-784-1410
Fax Number	:

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	03/30/2021

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