1699743138 NPI number — MICHAELE A. CRAWFORD, DPM, LLC

Table of content: (NPI 1699743138)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699743138 NPI number — MICHAELE A. CRAWFORD, DPM, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAELE A. CRAWFORD, DPM, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699743138
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
164 POINT PLZ
Provider Second Line Business Mailing Address:
SUITE 203
Provider Business Mailing Address City Name:
BUTLER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16001-2540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-282-0900
Provider Business Mailing Address Fax Number:
724-284-1233

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
164 POINT PLZ
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
BUTLER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16001-2540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-282-0900
Provider Business Practice Location Address Fax Number:
724-284-1233
Provider Enumeration Date:
03/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CRAWFORD
Authorized Official First Name:
MICHAELE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
724-282-0900

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 130053 . This is a "UNISON GROUP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1632058 . This is a "HIGHMARK GROUP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3106973 . This is a "USHC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7745378 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 243148 . This is a "HEALTH AMERICA GROUP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: DC0486 . This is a "RAILROAD MEDICARE #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 101193236 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: SC004652R . This is a "CHAMPUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1538599 . This is a "GATEWAY GROUP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 303675 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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