Provider Demographics
NPI:1962770180
Name:JOANNE G, CRANTZ M.D. LLC
Entity type:Organization
Organization Name:JOANNE G, CRANTZ M.D. LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:G
Authorized Official - Last Name:CRANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-560-8877
Mailing Address - Street 1:8316 ARLINGTON BLVD
Mailing Address - Street 2:615
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5207
Mailing Address - Country:US
Mailing Address - Phone:703-560-8877
Mailing Address - Fax:703-560-8869
Practice Address - Street 1:8316 ARLINGTON BLVD
Practice Address - Street 2:615
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5207
Practice Address - Country:US
Practice Address - Phone:703-560-8877
Practice Address - Fax:703-560-8869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038714207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty