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General NPI Number Information
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NPI Number | 1346279155
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Entity Type | Organization
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Legal Business Name | CROSSROADS MEDICAL ASSOCIATES, PLLC
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 12/31/2007
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Provider Practice Location Address
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Address Line | 1320 CENTRAL PARK BLVD
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4942
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Country | US
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Telephone | 540-785-9500
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Fax | 540-785-0206
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Provider Business Mailing Address
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Address Line | 1320 CENTRAL PARK BLVD
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4942
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Country | US
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Telephone | 540-785-9500
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Fax | 540-785-0206
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ENEYA MULAGHA
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Credential | M.D.
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Telephone | 540-785-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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