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Organization

CENTREVILLE FAMILY PRACTICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD BOXLEY BOWLES M.D. (PRESIDENT)
(703) 631-0331
Entity
Organization

Contact information

Practice address
13890 BRADDOCK RD, SUITE 201, CENTREVILLE, VA 20121-2435
(703) 631-0331
(703) 631-2573
Mailing address
13890 BRADDOCK RD, SUITE 201, CENTREVILLE, VA 20121-2435
(703) 631-0331
(703) 631-2573

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0100537
UNITED HEALTH CARE
VA
01
015385
ANTHEM BOWLES
VA
01
054086
ANTHEM KEYES
VA
01
299284
AMERIGROUP KEYES
VA
01
299304
AMERIGROUP BOWLES
VA
05
5674719
VA
01
7118167002
CIGNA BOWLES
VA
01
7526767001
CIGNA KEYES
VA
01
84280002
CAREFIRST BOWLES
VA
01
84280003
CAREFIRST KEYES
VA
01
898399
AETNA BOWLES
VA
01
898405
AETNA KEYES
VA
Enumeration date
10/16/2006
Last updated
08/22/2020
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