Healthcare Provider Details
I. General information
NPI: 1376565937
Provider Name (Legal Business Name): COMMUNITY MEDICINE UNIVERSITY OF VIRGINIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/24/2006
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2955 IVY ROAD SUITE 205
CHARLOTTESVILLE VA
22908-1205
US
IV. Provider business mailing address
2955 IVY ROAD SUITE 205
CHARLOTTESVILLE VA
22908-1205
US
V. Phone/Fax
- Phone: 434-243-4500
- Fax: 434-293-8570
- Phone: 434-243-4500
- Fax: 434-293-8570
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BARBARA
T
POST
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 434-243-4500