Provider Demographics
NPI:1922181007
Name:COMMONWEALTH NEONATOLOGY, INC.
Entity Type:Organization
Organization Name:COMMONWEALTH NEONATOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BONITA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:MAKDAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-282-8082
Mailing Address - Street 1:412 LIBBIE AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2658
Mailing Address - Country:US
Mailing Address - Phone:804-282-8082
Mailing Address - Fax:804-282-9082
Practice Address - Street 1:412 LIBBIE AVE STE 4
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2658
Practice Address - Country:US
Practice Address - Phone:804-282-8082
Practice Address - Fax:804-282-9082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty