Provider Demographics
NPI:1487697868
Name:CROSS, DAVID SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:CROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8409 NORTH RUN MEDICAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116
Mailing Address - Country:US
Mailing Address - Phone:804-569-6240
Mailing Address - Fax:804-569-6244
Practice Address - Street 1:8409 NORTH RUN MEDICAL DRIVE
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116
Practice Address - Country:US
Practice Address - Phone:804-569-6240
Practice Address - Fax:804-569-6244
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101048206207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6502253Medicaid
VA208175OtherANTHEM BS
1000087OtherUNITED HEALTHCARE
CF29490Medicare UPIN
VA6502253Medicaid