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Individual

CARLOS CRUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9231 HIDDEN MOUNTAIN DR, CHATTANOOGA, TN 37421-7423
(504) 913-2789
Mailing address
9231 HIDDEN MOUNTAIN DR, CHATTANOOGA, TN 37421-7423
(504) 913-2789

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
13866R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1572331
LA
01
561696907C
BLUE CROSS
LA
01
A127
CHAMPUS
LA
Enumeration date
06/09/2006
Last updated
10/31/2011
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