Individual
CHARLES DAVID CROUSE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1524 APPERSON DR, SALEM, VA 24153-7219
(434) 989-5281
Mailing address
1524 APPERSON DR, SALEM, VA 24153-7219
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101236620
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010079624
VIRGINIA PREMIER (MEDICAID HMO)
—
05
—
010079624
—
VA
01
—
10-01813
UNITED HEALTHCARE OF VIRGINIA
—
01
—
183014
ANTHEM AND HEALTHKEEPERS
—
01
—
3123459
MAMSI HEALTH PLANS
—
01
—
316948
SOUTHERN HEALTH
—
01
—
7432600
AETNA US HEALTHCARE
—
01
—
P00276841
MEDICARE RAILROAD
VA
01
—
TN0113
RIVER VALLEY
—
Enumeration date
12/21/2005
Last updated
01/21/2010
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