Provider Demographics
NPI:1700845625
Name:CRIMALDI, ANTHONY J II (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:CRIMALDI
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:500 MARTHA JEFFERSON DR
Mailing Address - Street 2:PHILLIPS CANCER CENTER
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-4668
Mailing Address - Country:US
Mailing Address - Phone:434-654-8125
Mailing Address - Fax:434-654-8127
Practice Address - Street 1:500 MARTHA JEFFERSON DR
Practice Address - Street 2:PHILLIPS CANCER CENTER
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4668
Practice Address - Country:US
Practice Address - Phone:434-654-8125
Practice Address - Fax:434-654-8127
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2005003212085R0001X
SC276482085R0001X
VA01012379132085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI36876Medicare PIN
NC2043113AMedicare ID - Type UnspecifiedMATTHEWS RAD ONC CTR
806971OtherPARTNERS
NC2043113CMedicare ID - Type UnspecifiedLAKE NORMAN RAD ONC CTR
NC2043113BOtherUNIVERSITY RAD ONC CTR
2544167OtherUNITED HEALTHCARE
5637505OtherCIGNA
NC5901500Medicaid
NCN0032BMedicaid
NCI36876Medicare UPIN
NC2043113Medicare ID - Type Unspecified
NC140EROtherBLUE CROSS
E4071OtherMEDCOST