Provider Demographics
NPI:1326038894
Name:CARMINES, HENRY B (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:B
Last Name:CARMINES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:860 OMNI BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8777
Mailing Address - Fax:757-232-8866
Practice Address - Street 1:12655 WARWICK BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2501
Practice Address - Country:US
Practice Address - Phone:757-595-9880
Practice Address - Fax:757-595-6895
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2011-08-25
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Provider Licenses
StateLicense IDTaxonomies
VA0101035861207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5619106Medicaid
VA080164528OtherRAILROAD MEDICARE
VA5619106Medicaid
VA080007433Medicare ID - Type Unspecified