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Organization
CENTREVILLE FAMILY PRACTICE
Active
Organization
CENTREVILLE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD BOXLEY BOWLES M.D. (PRESIDENT)
(703) 631-0331
Entity
Organization
Contact information
Practice address
13890 BRADDOCK RD, SUITE 201, CENTREVILLE, VA 20121-2435
(703) 631-0331
(703) 631-2573
Mailing address
13890 BRADDOCK RD, SUITE 201, CENTREVILLE, VA 20121-2435
(703) 631-0331
(703) 631-2573
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
—
0100537
UNITED HEALTH CARE
VA
01
—
015385
ANTHEM BOWLES
VA
01
—
054086
ANTHEM KEYES
VA
01
—
299284
AMERIGROUP KEYES
VA
01
—
299304
AMERIGROUP BOWLES
VA
05
—
5674719
—
VA
01
—
7118167002
CIGNA BOWLES
VA
01
—
7526767001
CIGNA KEYES
VA
01
—
84280002
CAREFIRST BOWLES
VA
01
—
84280003
CAREFIRST KEYES
VA
01
—
898399
AETNA BOWLES
VA
01
—
898405
AETNA KEYES
VA
Enumeration date
10/16/2006
Last updated
08/22/2020
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