Provider Demographics
NPI:1396793980
Name:MORGAN, JOHN IRVIN IV (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:IRVIN
Last Name:MORGAN
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:IRVIN
Other - Last Name:MORGAN
Other - Suffix:IV
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 13700-1369
Mailing Address - Street 2:COMMONWEALTH EMERGENCY PHYSICIANS PC
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19191-1369
Mailing Address - Country:US
Mailing Address - Phone:800-666-2455
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:44045 RIVERSIDE PARKWAY
Practice Address - Street 2:LOUDOUN HOSPITAL CENTER
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-858-6040
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234392207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA01000800Medicaid
VA01000800Medicaid
H69779Medicare UPIN