Crossover Medical LLC
Organization Active NPI Family Medicine Physician · Annadale, VA
NPI 1023719366 · NPPES record last updated Mar 14, 2023
Key facts
- NPI
- 1023719366
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CROSSOVER MEDICAL LLC
- Practice address
- 6922 Little River Turnpike
Suite D
Annadale, VA 22003 - Phone
- (703) 705-9306
- Fax
- (703) 890-3114
- NPI assigned
- Mar 14, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- CROSSOVER MEDICAL LLC
Authorized official
- Name
- Dr. Rotimi Adegoke Iluyomade, M.D.
- Title
- Medical Director/Ceo
- Phone
- (301) 379-7736
Practitioners 1
National Provider Directory
- Part of
- Crossover Medical LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Adult Development & Aging Psychologist |
103TA0700X | |||
| Integrative Medicine Physician |
202D00000X | |||
| Family Medicine Physician |
207Q00000X | Yes | ||
| Addiction Medicine (Family Medicine) Physician |
207QA0401X | |||
| Adult Medicine Physician |
207QA0505X | |||
| General Practice Physician |
208D00000X |
Addresses
Primary practice location
6922 Little River Turnpike
Suite D
Annadale, VA 22003
Mailing address
6922 Little River Turnpike
Suite D
Annadale, VA 22003
Phone (703) 705-9306
Other names
- CROSSOVER MEDICAL CENTER
Other providers in Annadale, VA
All providers in Annadale, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.