Crossover Medical LLC
Family Medicine in Annadale, VA. Organization (NPI-2).
NPI number1023719366
StatusActive
Last updated in NPPESMar 14, 2023
Details
- NPI
- 1023719366
- Entity type
- Organization (NPI-2)
- Legal business name
- Crossover Medical LLC
- Organization subpart
- Yes
- Enumeration date
- Mar 14, 2023
- Certification date
- Mar 14, 2023
- Last updated
- Mar 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207QA0401X | Family Medicine, Addiction Medicine | – | – | |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | |
| 103TA0700X | Psychologist, Adult Development & Aging | – | – | |
| 202D00000X | Integrative Medicine | – | – | |
| 207QA0505X | Family Medicine, Adult Medicine | – | – | |
| 208D00000X | General Practice | – | – |
Other names
- Crossover Medical Center (Doing Business As)
Practice location
6922 Little River TurnpikeSuite D
Annadale, VA 22003
Phone 703-705-9306 · Fax 703-890-3114
Mailing address
6922 Little River TurnpikeSuite D
Annadale, VA 22003
Phone 703-705-9306
Authorized official
Rotimi Adegoke Iluyomade
Medical Director/Ceo
3013797736
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