1720016330 NPI number — CHRISTOPHER H CROWE MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720016330 NPI number — CHRISTOPHER H CROWE MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

CROWE

Provider First Name:

CHRISTOPHER

Provider Middle Name:

H

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

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:

1720016330

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/15/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 6001

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

FARGO

Provider Business Mailing Address State Name:

ND

Provider Business Mailing Address Postal Code:

58108-6001

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

701-364-8000

Provider Business Mailing Address Fax Number:

701-364-8078

Provider First Line Business Practice Location Address:

3000 32ND AVE S

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

FARGO

Provider Business Practice Location Address State Name:

ND

Provider Business Practice Location Address Postal Code:

58103-6132

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

701-364-8000

Provider Business Practice Location Address Fax Number:

701-364-8078

Provider Enumeration Date:

06/30/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  6786 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 142006 . This is a "UCARE #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 9639 . This is a "SIOUX VALLEY #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 1600846 . This is a "FGO MEDICA #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 3T306CR . This is a "MNBS #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 010218100 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
• Identifier: 11984 . This is a "NDBS #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 900602 . This is a "ARAZ #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: DA9011015526 . This is a "PREF 1 #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 1600844 . This is a "INN MEDICA #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
• Identifier: 17853 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
• Identifier: HP25732 . This is a "HEALTHPARTNERS #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".