Individual
DR. HALBERTO G. CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-9308
(304) 645-4043
(304) 645-4713
Mailing address
PO BOX 671, LEWISBURG, WV 24901-0671
(304) 645-4043
(304) 645-4713
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11994
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0123032000
—
WV
01
—
288546
MAMSI
WV
01
—
55073865301
CHAMPUS
—
Enumeration date
10/26/2006
Last updated
07/08/2007
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