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Organization
COMMONWEALTH PRIMARY CARE
Active
Organization
COMMONWEALTH PRIMARY CARE
Active
Other names
Patterson Avenue Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL DANIEL (BILLING ADMINISTRATOR)
(804) 288-0399
Entity
Organization
Contact information
Practice address
10431 PATTERSON AVE, RICHMOND, VA 23233
(804) 741-6200
(804) 545-0147
Mailing address
8002 DISCOVERY DRIVE, SUITE 410, RICHMOND, VA 23229
(804) 288-0399
(804) 285-0088
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
292413
ANTHEM
VA
01
—
CK5367
RAILROAD MEDICARE
VA
Enumeration date
08/02/2006
Last updated
11/28/2007
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