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Organization
COMMONWEALTH FAMILY PHYSICIANS, INC.
Active
Organization
COMMONWEALTH FAMILY PHYSICIANS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYRON EDWARD ELLER JR. M.D. (CEO/PRESIDENT)
(276) 632-3841
Entity
Organization
Contact information
Practice address
445 COMMONWEALTH BLVD E, MARTINSVILLE, VA 24112-2014
(276) 632-3841
(276) 632-2437
Mailing address
445 COMMONWEALTH BLVD E, MARTINSVILLE, VA 24112-2014
(276) 632-3841
(276) 632-2437
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
—
466796
ANTHEM GROUP NUMBER
VA
01
—
CB1505
RAILROAD MEDICARE GROUP #
VA
Enumeration date
08/17/2006
Last updated
08/22/2020
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