Provider Demographics
NPI:1083620843
Name:CROSS, PATRICK ANDRE (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ANDRE
Last Name:CROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:9733 CLAGETT FARM DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2087
Mailing Address - Country:US
Mailing Address - Phone:202-422-7653
Mailing Address - Fax:
Practice Address - Street 1:7501 GREENWAY CENTER DR STE 500
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3546
Practice Address - Country:US
Practice Address - Phone:301-373-7900
Practice Address - Fax:301-373-6900
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041728207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC035145300Medicaid
MD362201100Medicaid
DCP00407332OtherRAILROAD MEDICARE
MD403272100Medicaid
KA73OtherBLUE CROSS/BLUE SHEILD
DCP00407332OtherRAILROAD MEDICARE