# CARY STREET FAMILY PRACTICE

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

## Provider details

- **NPI number:** 1396968392
- **Authorized official:** MS. BEVERLY BROOKS DEATS (OFFICE COORDINATOR)
- **Authorized official phone:** (804) 353-0010

## Contact information

- **Practice address:** 4906 CUTSHAW AVE, SUITE 102, RICHMOND, VA 23230-3630
- **Practice address phone:** (804) 353-0010
- **Practice address fax:** (804) 278-8796
- **Mailing address:** 4906 CUTSHAW AVE, SUITE 102, RICHMOND, VA 23230-3630
- **Mailing address phone:** (804) 353-0010
- **Mailing address fax:** (804) 278-8796

## Taxonomy

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

## Other

- **Enumeration date:** 04/10/2007
- **Last updated:** 08/22/2020