Provider Demographics
NPI:1609841394
Name:HERRE, JOHN MILTON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MILTON
Last Name:HERRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MEDICAL PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4985
Mailing Address - Country:US
Mailing Address - Phone:757-252-5660
Mailing Address - Fax:757-548-9443
Practice Address - Street 1:300 MEDICAL PKWY STE 120
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4985
Practice Address - Country:US
Practice Address - Phone:757-252-5660
Practice Address - Fax:757-548-9443
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101035430207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006000509Medicaid
VA15792OtherSENTARA OHP/SHP
VAPAROtherMULTIPLAN
VA-001OtherTRICARE/CHAMPUS
VA006040802Medicaid
VA050275OtherANTHEM
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VAPAROtherVIRGINIA HEALTH NETWORK
VA250147OtherANTHEM
VAPAROtherCIGNA
VA0513MOtherBC/BS NC
VAPAROtherAETNA
NC890513MMedicaid
VAPAROtherUSA MANAGED CARE
VAPAROtherCORVEL/CORCARE
VAPAROtherVIRGINIA PREMIER HEALTH
VA15601OtherOPTIMA
VA249503OtherMAMSI
VA263654OtherUHC/MAMSI
VA263654OtherUHC/MAMSI
VA250147OtherANTHEM
VAPAROtherMULTIPLAN
VAPAROtherCIGNA
VA060019289Medicare PIN