# CENTREVILLE-CHANTILLY FAMILY PRACTICE

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

## Provider details

- **NPI number:** 1558550558
- **Authorized official:** PAIGE RHODES (OFFICE MANAGER)
- **Authorized official phone:** (703) 631-5151

## Contact information

- **Practice address:** 5715 CENTRE SQUARE DR, CENTREVILLE, VA 20120-1916
- **Practice address phone:** (703) 631-5151
- **Practice address fax:** (703) 631-9754
- **Mailing address:** 5715 CENTRE SQUARE DR, CENTREVILLE, VA 20120-1916
- **Mailing address phone:** (703) 631-5151
- **Mailing address fax:** (703) 631-9754

## Taxonomy

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

## Other

- **Enumeration date:** 10/16/2007
- **Last updated:** 07/30/2008