MEDICARE: COMMONWEALTH SLEEP ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	0101236604	VA
2	207R00000X	Internal Medicine Physician	0101236604	VA
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	0101236604	VA

General Provider Information

NPI Number	:	1538565635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMONWEALTH SLEEP ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 6626
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23058-6626
Country	:	US
Telephone Number	:	804-977-2728
Fax Number	:	804-977-2728

Provider Business Practice Location Address
First Line	:	4100 E PARHAM RD
Second Line	:	SUITE A
City	:	RICHMOND
State	:	VA
Zip	:	23228-2760
Country	:	US
Telephone Number	:	804-977-2728
Fax Number	:	804-977-2728

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ABDUL AMIR
Credential	:	MD
Telephone Number	:	804-977-2728

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	05/04/2017

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