Provider Demographics
NPI:1952399073
Name:PERRY, JOHN CURTIS (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CURTIS
Last Name:PERRY
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12200 WARWICK BLVD
Practice Address - Street 2:STE 290
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-2548
Practice Address - Country:US
Practice Address - Phone:757-534-5454
Practice Address - Fax:757-534-5491
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2014-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101229942207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI36235Medicare UPIN
VAP00670953Medicare PIN
VA018183R53Medicare PIN
VA1952399073Medicaid