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Contact Information

COMMONWEALTH PRIMARY CARE
4050 INNSLAKE DR
STE 308
GLEN ALLEN, VA23060
 Phone: 804-521-5310
 Fax: 804-521-5312
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for COMMONWEALTH PRIMARY CARE · (Female)

NPI Number 1336157858
Status Active
Credentials
Entity Individual
Enumeration date 08/03/2006
Last updated 11/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • VA Other 139440 ANTHEM BCBS
  • VA Other 139444 ANTHEM BCBS
  • VA Other CC6597 MEDICARE RR
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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