Provider Demographics
NPI:1417926858
Name:CRANTZ, JOANNE G (MD)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:G
Last Name:CRANTZ
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 1:8316 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 615
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5207
Mailing Address - Country:US
Mailing Address - Phone:703-560-8877
Mailing Address - Fax:706-560-8869
Practice Address - Street 1:8316 ARLINGTON BLVD
Practice Address - Street 2:SUITE 615
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5207
Practice Address - Country:US
Practice Address - Phone:703-560-8877
Practice Address - Fax:706-560-8869
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101038714207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA208055OtherANTHEM
VA25790004OtherCAREFIRST BC/BS
VA5853192Medicaid
VAC87801Medicare UPIN
VA208055OtherANTHEM