Organization
COMMONWEALTH INTERNAL MEDICINE & GERIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HENGLY KY (PRESIDENT)
(804) 883-0052
Entity
Organization
Contact information
Practice address
16618 MOUNTAIN RD, SUITE B, MONTPELIER, VA 23192-2649
(804) 883-0052
(804) 883-0054
Mailing address
330 PEMBROKE LN, RICHMOND, VA 23238-6221
(804) 545-6860
(804) 213-9783
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356679138
PHYSICIAN NPI
VA
Enumeration date
03/20/2006
Last updated
05/14/2010
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