Individual
MARK MANLUTAC CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2197
(757) 953-3500
Mailing address
1725 FISHERS CV, CHESAPEAKE, VA 23321-1992
(757) 477-6124
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
T63028072
VA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0101252328
VA
Other
Enumeration date
07/17/2011
Last updated
08/26/2020
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