Provider Demographics
NPI:1326064163
Name:WARKENTIN, JOHN R (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:WARKENTIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1000 BOULDERS PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5545
Mailing Address - Country:US
Mailing Address - Phone:804-320-4243
Mailing Address - Fax:804-282-1486
Practice Address - Street 1:1603 SANTA ROSA RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5010
Practice Address - Country:US
Practice Address - Phone:804-320-4243
Practice Address - Fax:804-622-0552
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2013-11-14
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Provider Licenses
StateLicense IDTaxonomies
VA0101026633207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4800049OtherUNITED HEALTHCARE PROV #
VA00689540OtherBLACK LUNG PROVIDER NUMBE
VA290003786OtherMEDICARE RAILROAD
VA006051847Medicaid
VA32078OtherCARENET PROVIDER NUMBER
VA7101413OtherMAMSI PROVIDER NUMBER
VA021804OtherCIGNA
VA557515OtherAETNA PROVIDER NUMBER
VA59216OtherSOUTHERN HEALTH PROV #
VA083626OtherANTHEM PROVIDER NUMBER
VA006051847Medicaid
VA290003786OtherMEDICARE RAILROAD