| Doctor Name: | DR. CRYSTAL MILLER PROUD |
| NPI Number: | 1013159177 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 0101258310 |
| Business Practice Address: | 850 Southampton Ave Norfolk, VA - 235101021 |
| Business Phone Number: | 7576689920 |
| Business Fax Number: | 7576689930 |
| Mailing Address: | 850 Southampton Ave, NORFOLK |
| State: | VA |
| Postal Code: | 235101021 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/03/2009 |
| NPI Last Update Date: | 10/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084N0008X |
| License Number: | 0101258310 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Neuromuscular Medicine |
| Taxonomy Definition: | A neurologist or child neurologist who specializes in the diagnosis and management of disorders of nerve, muscle or neuromuscular junction, including amyotrophic lateral sclerosis, peripheral neuropathies (e.g., diabetic and immune mediated neuropathies), various muscular dystrophies, congenital and acquired myopathies, inflammatory myopathies (e.g., polymyositis, inclusion body myositis) and neuromuscular transmission disorders (e.g., myasthenia gravis, Lambert-Eaton myasthenic syndrome). |