# CENTREVILLE FAMILY PRACTICE

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

## Provider details

- **NPI number:** 1467532218
- **Authorized official:** RICHARD BOXLEY BOWLES M.D. (PRESIDENT)
- **Authorized official phone:** (703) 631-0331

## Contact information

- **Practice address:** 13890 BRADDOCK RD, SUITE 201, CENTREVILLE, VA 20121-2435
- **Practice address phone:** (703) 631-0331
- **Practice address fax:** (703) 631-2573
- **Mailing address:** 13890 BRADDOCK RD, SUITE 201, CENTREVILLE, VA 20121-2435
- **Mailing address phone:** (703) 631-0331
- **Mailing address fax:** (703) 631-2573

## Taxonomy

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

## Other

- **Enumeration date:** 10/16/2006
- **Last updated:** 08/22/2020

## 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 |