Organization
COMMONWEALTH CRITICAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HOMEYER MD (SOLE MEMBER)
(703) 858-6044
Entity
Organization
Contact information
Practice address
2501 PARKERS LN, ALEXANDRIA, VA 22306-3209
(703) 664-7000
Mailing address
PO BOX 34834, ALEXANDRIA, VA 22334-4834
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
08/09/2017
Last updated
08/09/2017
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