| Commonwealth Family Practice Ltd | |
|
10201 Krause Rd Chesterfield VA 23832-6575 | |
| (804) 748-6229 | |
| (804) 748-5909 |
| Full Name | Commonwealth Family Practice Ltd |
|---|---|
| Speciality | General Practice |
| Location | 10201 Krause Rd, Chesterfield, Virginia |
| Authorized Official Name and Position | Marianne Land Siegrist (VICE PRESIDENT CEO) |
| Authorized Official Contact | 8047486229 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Family Practice Ltd 10201 Krause Rd Chesterfield VA 23832-6575 Ph: (804) 748-6229 | Commonwealth Family Practice Ltd 10201 Krause Rd Chesterfield VA 23832-6575 Ph: (804) 748-6229 |
| NPI Number | 1215936547 |
|---|---|
| Provider Enumeration Date | 07/19/2005 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215936547 | NPI | - | NPPES |
| 287512 | Other | BLUE CROSS | |
| 287512 | Other | BLUE CROSS-BLUE SHIELD | |
| 318871 | Other | BLUE CROSS/BLUE SHIELD | |
| H9571 | Other | RAILROAD MEDICARE | |
| 318871 | Other | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 0102037170 (Virginia) | Primary |
| 208D00000X | General Practice | 0102037160 (Virginia) | Secondary |
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