# COMMONWEALTH PRIMARY CARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Patterson Avenue Family Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174530257
- **Authorized official:** MS. CHERYL DANIEL (BILLING ADMINISTRATOR)
- **Authorized official phone:** (804) 288-0399

## Contact information

- **Practice address:** 10431 PATTERSON AVE, RICHMOND, VA 23233
- **Practice address phone:** (804) 741-6200
- **Practice address fax:** (804) 545-0147
- **Mailing address:** 8002 DISCOVERY DRIVE, SUITE 410, RICHMOND, VA 23229
- **Mailing address phone:** (804) 288-0399
- **Mailing address fax:** (804) 285-0088

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/02/2006
- **Last updated:** 11/28/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 292413 | ANTHEM | VA |
| 01 | — | CK5367 | RAILROAD MEDICARE | VA |