| Commonwealth Gastroenterology, Pc | |
|
4000a Glenside Dr Henrico VA 23228-4102 | |
| (804) 716-6318 | |
| (804) 801-5187 |
| Full Name | Commonwealth Gastroenterology, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4000a Glenside Dr, Henrico, Virginia |
| Authorized Official Name and Position | Erin Dalton (CREDENTIALING) |
| Authorized Official Contact | 7578706595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Gastroenterology, Pc 1215 N 26th St Richmond VA 23223-5211 Ph: (757) 870-6595 | Commonwealth Gastroenterology, Pc 4000a Glenside Dr Henrico VA 23228-4102 Ph: (804) 716-6318 |
| NPI Number | 1699403063 |
|---|---|
| Provider Enumeration Date | 08/12/2022 |
| Last Update Date | 08/18/2022 |
| Medicare PECOS PAC ID | 3274909379 |
|---|---|
| Medicare Enrollment ID | O20221014000230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699403063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Scott D Woogen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215939251 PECOS PAC ID: 7416056726 Enrollment ID: I20070627000707 |
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