Provider Demographics
NPI:1326005414
Name:MORINA, JOHN M (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:MORINA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:230 CLEARFIELD AVENUE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:VA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462
Mailing Address - Country:US
Mailing Address - Phone:757-321-3383
Mailing Address - Fax:757-321-3332
Practice Address - Street 1:1800 CAMELOT DR
Practice Address - Street 2:STE 300
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454
Practice Address - Country:US
Practice Address - Phone:757-321-3383
Practice Address - Fax:757-321-3332
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2015-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101038177207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA640Medicaid
B10070Medicare UPIN
VA640Medicaid