Individual
LISA M CRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8316 TRAFORD LN, SPRINGFIELD, VA 22152
(703) 569-8400
(703) 569-1182
Mailing address
8316 TRAFORD LN, SPRINGFIELD, VA 22152
(703) 569-8400
(703) 569-1182
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101044137
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101044137
MEDICAL LICENSE #
VA
01
—
10369223
CAQH
—
01
—
4259717
AETNA POS PPO
—
01
—
840878
MAMSI OPTIMUM CHOICE MD I
—
01
—
876276
AETNA HMO
—
01
—
B9390007
CARE FIRST BCBS
—
Enumeration date
10/26/2006
Last updated
07/08/2007
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