Provider Demographics
NPI:1508821851
Name:CROSBY, FAITH BERNADETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:FAITH
Middle Name:BERNADETTE
Last Name:CROSBY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2312 WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3643
Mailing Address - Country:US
Mailing Address - Phone:336-608-4311
Mailing Address - Fax:336-272-2112
Practice Address - Street 1:719 GREEN VALLEY RD
Practice Address - Street 2:SUITE 209
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7014
Practice Address - Country:US
Practice Address - Phone:336-272-9447
Practice Address - Fax:336-272-2112
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2012-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC23503208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8925908Medicaid
NC8925908Medicaid