Individual
DR. PHUONGKHANH HUY CROMWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8264 GEORGE WASHINGTON MEMORIAL HWY, GLOUCESTER, VA 23061-4127
(804) 695-0305
Mailing address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-4805
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101268121
VA
208000000X
Pediatrics Physician
200201131
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1315V
BCBS NC
NC
01
—
370021704
RAILROAD MEDICARE
NC
05
—
891315V
—
NC
Enumeration date
09/12/2005
Last updated
11/23/2024
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