Provider Demographics
NPI:1013363043
Name:CROSEN, MATELIN PAUL (MD)
Entity Type:Individual
Prefix:
First Name:MATELIN
Middle Name:PAUL
Last Name:CROSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:220 CAMPUS BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2889
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:190 CAMPUS BLVD STE 310
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2872
Practice Address - Country:US
Practice Address - Phone:540-536-0130
Practice Address - Fax:540-536-0140
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012758562086S0102X, 2086S0127X
NCRTL21-09422086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care