Individual
CECIL BERNARD CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
44055 RIVERSIDE PKWY, SUITE 246, LEESBURG, VA 20176-5179
(703) 858-3200
(703) 858-3203
Mailing address
15935 CLARKES GAP RD, WATERFORD, VA 20197-1123
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101042337
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010071780
—
VA
01
—
P00142414
RR MEDICARE
—
Enumeration date
09/09/2005
Last updated
01/10/2024
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