Organization
COMMONWEALTH ALLERGY AND ASTHMA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY CREASY GEORGE M.D. (PHYSICIAN)
(540) 379-2707
Entity
Organization
Contact information
Practice address
201 CONCOURSE BLVD, STE 100, GLEN ALLEN, VA 23059-5640
(804) 968-4824
(804) 968-4826
Mailing address
201 CONCOURSE BLVD, STE 100, GLEN ALLEN, VA 23059-5640
(804) 968-4824
(804) 968-4826
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
0101239959
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Y236A02
MEDICARE
VA
05
—
1932130531
—
VA
Enumeration date
10/20/2010
Last updated
12/03/2010
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