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General NPI Number Information
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NPI Number | 1164757498
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Entity Type | Organization
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Legal Business Name | EDWIN CRUZ MD & CO. INC.
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 12/21/2009
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Provider Practice Location Address
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Address Line | 1712 STONE CHURCH MEWS
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-4374
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Country | US
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Telephone | 757-460-7447
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Fax |
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Provider Business Mailing Address
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Address Line | 1712 STONE CHURCH MEWS
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-4374
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Country | US
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Telephone | 757-460-7447
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | DR. EDWIN CRUZ
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Credential | MD
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Telephone | 757-460-7447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 0101221356
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License Number State | VA
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