Organization
UVA COMMUNITY HEALTH MEDICAL GROUP, LLC
Active
Other names
UVA Health Bull Run Family Medicine Bristow
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES D CODER (CFO)
(804) 835-2069
Entity
Organization
Contact information
Practice address
10322 BRISTOW CENTER DR, BRISTOW, VA 20136-2201
(571) 284-4230
(703) 257-1495
Mailing address
PO BOX 748613, ATLANTA, GA 30384-8613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
09/26/2023
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