Individual
DR. FREDERICK C CRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3235 ACADEMY AVE, SUITE 102, PORTSMOUTH, VA 23703-3200
(757) 484-7386
(757) 484-1913
Mailing address
3235 ACADEMY AVE, SUITE 102, PORTSMOUTH, VA 23703-3200
(757) 484-7386
(757) 484-1913
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101038607
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005634245
—
VA
01
—
073257
ANTHEM
VA
Enumeration date
07/07/2006
Last updated
09/27/2011
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