Healthcare Provider Details

I. General information

NPI: 1104917954
Provider Name (Legal Business Name): COMMONWEALTH PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7023 OLD JAHNKE RD
RICHMOND VA
23225
US

IV. Provider business mailing address

7023 OLD JAHNKE RD
RICHMOND VA
23225
US

V. Phone/Fax

Practice location:
  • Phone: 804-320-1353
  • Fax: 804-320-6636
Mailing address:
  • Phone: 804-320-1353
  • Fax: 804-320-6636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL M STHREHLER
Title or Position: PARTNER OF PRACTICE
Credential: MD
Phone: 804-320-1353