Provider Demographics
NPI:1003948324
Name:CROSS, ELIZABETH MCGILL (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MCGILL
Last Name:CROSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4704 BUCKINGHAM COURT
Mailing Address - Street 2:ELIZABETH M. CROSS, M.D.
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831
Mailing Address - Country:US
Mailing Address - Phone:804-796-2300
Mailing Address - Fax:804-751-4815
Practice Address - Street 1:4707 BUCKINGHAM CT
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-4261
Practice Address - Country:US
Practice Address - Phone:804-796-2300
Practice Address - Fax:804-751-4815
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010455372080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6745504Medicaid
VA6745504Medicaid