Provider Demographics
NPI:1326377490
Name:COMMONWEALTH PLASTIC SURGERY, P.C.
Entity Type:Organization
Organization Name:COMMONWEALTH PLASTIC SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:VIOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-383-6625
Mailing Address - Street 1:PO BOX 2576
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23327-2576
Mailing Address - Country:US
Mailing Address - Phone:757-383-6625
Mailing Address - Fax:
Practice Address - Street 1:113 GAINSBOROUGH SQ
Practice Address - Street 2:SUITE 400
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1713
Practice Address - Country:US
Practice Address - Phone:757-549-2492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-18
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232284208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty