Provider Demographics
NPI:1285613596
Name:CROSS, HAROLD DICK (MD)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:DICK
Last Name:CROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 ROBERT SMALLS PKWY
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906-3702
Mailing Address - Country:US
Mailing Address - Phone:843-521-4357
Mailing Address - Fax:843-521-4566
Practice Address - Street 1:272 ROBERT SMALLS PKWY
Practice Address - Street 2:SUITE 320
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-3702
Practice Address - Country:US
Practice Address - Phone:843-521-4357
Practice Address - Fax:843-521-4566
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2013-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC20545207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5959335OtherBC
C66517Medicare UPIN