Basic Information
| Provider Information | |||||||||
| NPI: | 1992775902 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CROWE | ||||||||
| FirstName: | NEIL | ||||||||
| MiddleName: | WARD | ||||||||
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| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 125 A MEDICAL CIR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226013300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406671828 | ||||||||
| FaxNumber: | 5407223658 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 MEDICAL CIR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226013300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406671828 | ||||||||
| FaxNumber: | 5407223658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2006 | ||||||||
| LastUpdateDate: | 03/11/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 0101044980 | VA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 001717357 | 01 | VA | MOUNTAIN STATE BCBS | OTHER | 0089921000 | 01 | WV | MEDICAID | OTHER | 289216 | 01 | VA | ANTHEM | OTHER | 006100562 | 05 | VA | MEDICAID | 130005574 | 01 | VA | RAILROAD MEDICARE | OTHER |