Organization
COMMONWEALTH PRIMARY CARE
Active
Other names
Patterson Avenue Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL DANIEL (BILLING ADMINISTRATOR)
(804) 288-0399
Entity
Organization
Contact information
Practice address
10431 PATTERSON AVE, RICHMOND, VA 23233
(804) 741-6200
(804) 545-0147
Mailing address
8002 DISCOVERY DRIVE, SUITE 410, RICHMOND, VA 23229
(804) 288-0399
(804) 285-0088
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
292413
ANTHEM
VA
01
—
CK5367
RAILROAD MEDICARE
VA
Enumeration date
08/02/2006
Last updated
11/28/2007
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