Crossover Medical LLC

NPI #1023719366 in Annadale, Virginia

Provider Information

NPI Number: 1023719366
Entity Type: Organization
Organization Name: Crossover Medical LLC
Subpart: Yes (part of a larger organization)
Parent Organization: CROSSOVER MEDICAL LLC
Primary Specialty: Family Medicine
Enumeration Date: Mar 14, 2023
Last Updated: Mar 14, 2023

Practice Location

Address: 6922 LITTLE RIVER TURNPIKE
Address 2: SUITE D
City: Annadale
State: Virginia
ZIP Code: 22003
Phone: (703) 705-9306

Authorized Official

Name: DR. ROTIMI ADEGOKE ILUYOMADE, M.D.
Title: MEDICAL DIRECTOR/CEO
Phone: (301) 379-7736

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine - Addiction Medicine — Addiction Medicine	207QA0401X
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Psychologist - Adult Development & Aging — Adult Development & Aging	103TA0700X
Integrative Medicine	202D00000X
Family Medicine - Adult Medicine — Adult Medicine	207QA0505X
General Practice	208D00000X
Family Medicine	207Q00000X	Primary

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