Healthcare Provider Details

I. General information

NPI: 1821866732
Provider Name (Legal Business Name): NEVILLE HUNTER CROSS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 E LANE ST
RALEIGH NC
27610-2323
US

IV. Provider business mailing address

5617 RAMSEY ST
FAYETTEVILLE NC
28311-1423
US

V. Phone/Fax

Practice location:
  • Phone: 919-673-6133
  • Fax:
Mailing address:
  • Phone: 910-483-7337
  • Fax: 910-493-0648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: