Healthcare Provider Details

I. General information

NPI: 1548213549
Provider Name (Legal Business Name): COMMONWEALTH SURGEONS, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 BREMO RD SUITE 506
RICHMOND VA
23226-1926
US

IV. Provider business mailing address

5855 BREMO RD SUITE 506
RICHMOND VA
23226-1926
US

V. Phone/Fax

Practice location:
  • Phone: 804-285-3225
  • Fax: 804-285-0360
Mailing address:
  • Phone: 804-285-3225
  • Fax: 804-285-0360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number StateVA

VIII. Authorized Official

Name: SYLVIA A. OWENS
Title or Position: ADMINISTRATOR
Credential:
Phone: 804-285-3225