# CHARLES CITY MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043267693
- **Authorized official:** DR. LERLA G JOSEPH M.D. (PRESIDENT/PHYSICIAN)
- **Authorized official phone:** (804) 230-4913

## Contact information

- **Practice address:** 921 HULL ST, RICHMOND, VA 23224-4069
- **Practice address phone:** (804) 230-4913
- **Practice address fax:** (804) 233-7034
- **Mailing address:** 921 HULL ST, RICHMOND, VA 23224-4069
- **Mailing address phone:** (804) 230-4913
- **Mailing address fax:** (800) 609-6810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | 0101052550 | VA | Yes |

## Other

- **Enumeration date:** 05/28/2006
- **Last updated:** 07/09/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5620911 | — | VA |