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NPI Code Detail

MEDICARE: ANNA L CRUTCHFIELD M.D.

MEDICARE: ANNA L CRUTCHFIELD M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QS0010XSports Medicine (Family Medicine) Physician0101270214VA
2207Q00000XFamily Medicine PhysicianLL39425SC
3207Q00000XFamily Medicine Physician0101270214VA

General Provider Information

NPI Number : 1710336029
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA L CRUTCHFIELD M.D.
Provider Business Mailing Address
First Line : PO BOX 37189
Second Line :
City : BALTIMORE
State : MD
Zip : 21297-3189
Country : US
Telephone Number : 571-423-5699
Fax Number : 571-423-5698
Provider Business Practice Location Address
First Line : 3650 JOSEPH SIEWICK DR STE 400
Second Line :
City : FAIRFAX
State : VA
Zip : 22033-1715
Country : US
Telephone Number : 703-391-2020
Fax Number : 703-391-1211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2016
Last Update Date : 04/15/2026

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