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Contact Information

JOHN R WINE
412 NAMOZINE STREET
BURKEVILLE, VA23922
 Phone: 434-767-4822
 Fax: 434-767-2211
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for JOHN R WINE · (Male)

NPI # 1427040112
Status Active
Credentials
Entity Individual
Enumeration date 08/18/2005
Last updated 10/15/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 0101029100
  • VA Medicaid 1427040112
  • VA Medicaid 5633419
  • VA Other 4468872 AETNA
  • VA Other 345648 ANTHEM
  • VA Other 61459602 BLACK LUNG/FECA
  • VA Other 1108312 CIGNA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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