Provider Demographics
NPI:1760411581
Name:COMMONWEALTH PHYSICIANS FOR WOMEN, PC
Entity Type:Organization
Organization Name:COMMONWEALTH PHYSICIANS FOR WOMEN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-288-4452
Mailing Address - Street 1:1602 ROLLING HILLS DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5012
Mailing Address - Country:US
Mailing Address - Phone:804-282-5822
Mailing Address - Fax:804-282-4741
Practice Address - Street 1:5855 BREMO RD
Practice Address - Street 2:SUITE 605
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1926
Practice Address - Country:US
Practice Address - Phone:804-285-8806
Practice Address - Fax:804-288-6079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05556Medicare PIN
VAC04753Medicare PIN
VAC07081Medicare PIN