Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | D0041728 | MD |
Y | 207RX0202X | Medical Oncology | D0041728 | MD |
NPI | 1083620843 |
---|---|
Provider Name | Dr. Patrick Andre Cross |
First Address | Baltimore, MD 21279-1523 |
Second Address | Silver Spring, MD 20901-4460 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 23/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
035145300 | (05) | DC |
403272100 | (05) | MD |
F27578 | (02) | |
KA73 | BLUE CROSS/BLUE SHEILD (01) | |
P00407332 | RAILROAD MEDICARE (01) | DC |