Provider Demographics
NPI:1275850414
Name:CROSS, CHANTEL IANTHE (MD)
Entity type:Individual
Prefix:
First Name:CHANTEL
Middle Name:IANTHE
Last Name:CROSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHANTEL
Other - Middle Name:IANTHE
Other - Last Name:WASHINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8010 TOWERS CRESCENT DR FL 5
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2710
Mailing Address - Country:US
Mailing Address - Phone:571-789-2100
Mailing Address - Fax:
Practice Address - Street 1:8010 TOWERS CRESCENT DR FL 5
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2710
Practice Address - Country:US
Practice Address - Phone:571-789-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0077757207VE0102X
DCMD600001979207VE0102X
VA0101283469207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology