Individual
RODELL E CRUISE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2009 TIDEWATER COLONY DR, SUITE 1A, ANNAPOLIS, MD 21401-2107
(410) 224-0010
(410) 224-0012
Mailing address
2009 TIDEWATER COLONY DR, SUITE 1A, ANNAPOLIS, MD 21401-2107
(410) 224-0010
(410) 224-0012
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0054076
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005622093
—
VA
01
—
080180343
RAILROAD MEDICARE
GA
Enumeration date
08/26/2005
Last updated
03/20/2025
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