Organization
BON SECOURS-VIRGINIA HEALTHSOURCE
Active
Other names
Commonwealth Internal Medicine Associates
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE O. BUTLER MBA (DIRECTOR, CORPORATE RESPONSIBILITY)
(804) 281-0271
Entity
Organization
Contact information
Practice address
9220 FOREST HILL AVE, SUITE 1-A, RICHMOND, VA 23235
(804) 560-8838
(804) 560-3527
Mailing address
9220 FOREST HILL AVE, SUITE 1-A, RICHMOND, VA 23235-6800
(804) 560-8838
(804) 560-3527
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG5286
RAILROAD MEDICARE
VA
Enumeration date
07/08/2006
Last updated
07/27/2018
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