Organization
CROSSOVER MEDICAL LLC
Active
Parent organization
CROSSOVER MEDICAL LLC
Other names
CROSSOVER MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
CROSSOVER MEDICAL LLC
Authorized official
DR. ROTIMI ADEGOKE ILUYOMADE M.D. (MEDICAL DIRECTOR/CEO)
(301) 379-7736
Entity
Organization
Contact information
Practice address
6922 LITTLE RIVER TURNPIKE, SUITE D, ANNADALE, VA 22003
(703) 705-9306
(703) 890-3114
Mailing address
6922 LITTLE RIVER TURNPIKE, SUITE D, ANNADALE, VA 22003
(703) 705-9306
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
202D00000X
Integrative Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
03/14/2023
Last updated
03/14/2023
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