Provider Demographics
NPI:1528014578
Name:COMMONWEALTH INPATIENT PHYSICIANS, LLC
Entity Type:Organization
Organization Name:COMMONWEALTH INPATIENT PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:V
Authorized Official - Last Name:PUCCIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-858-6044
Mailing Address - Street 1:PO BOX 17668
Mailing Address - Street 2:COMMONWEALTH INPATIENT PHYSICIANS, LLC
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-1668
Mailing Address - Country:US
Mailing Address - Phone:610-668-6491
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:44045 RIVERSIDE PKWY
Practice Address - Street 2:INOVA LOUDOUN HOSPITAL
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-5101
Practice Address - Country:US
Practice Address - Phone:703-858-6044
Practice Address - Fax:610-617-6280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty