Provider Demographics
NPI:1568625135
Name:QUILLIN, JOHN MARTIN (PHD, MPH, MS, CGC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARTIN
Last Name:QUILLIN
Suffix:
Gender:M
Credentials:PHD, MPH, MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 E MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-5048
Mailing Address - Country:US
Mailing Address - Phone:804-628-1925
Mailing Address - Fax:804-827-4100
Practice Address - Street 1:1101 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5048
Practice Address - Country:US
Practice Address - Phone:804-628-1925
Practice Address - Fax:804-827-4100
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS