Healthcare Provider Details

I. General information

NPI: 1942364617
Provider Name (Legal Business Name): CENTRE POINTE HEALTH SPECIALTIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LEELAND RD STE 104
FREDERICKSBURG VA
22405-2129
US

IV. Provider business mailing address

10 LEELAND RD STE 104
FREDERICKSBURG VA
22405-2129
US

V. Phone/Fax

Practice location:
  • Phone: 540-947-9789
  • Fax: 202-519-3828
Mailing address:
  • Phone: 540-947-9789
  • Fax: 202-519-3828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHERIAN JOSEPH
Title or Position: PRESIDENT
Credential: MD
Phone: 540-947-9789