# CHURCHLAND FAMILY MEDICINE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871732784
- **Authorized official:** DR. FREDERICK C CRUM M.D. (PRESIDENT)
- **Authorized official phone:** (757) 484-7386

## Contact information

- **Practice address:** 3235 ACADEMY AVE, SUITE 102, PORTSMOUTH, VA 23703-3200
- **Practice address phone:** (757) 484-7386
- **Practice address fax:** (757) 484-1913
- **Mailing address:** 3235 ACADEMY AVE, SUITE 102, PORTSMOUTH, VA 23703-3200
- **Mailing address phone:** (757) 484-7386
- **Mailing address fax:** (757) 484-1913

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0101038607 | VA | Yes |

## Other

- **Enumeration date:** 02/17/2009
- **Last updated:** 02/17/2009