Healthcare Provider Details

I. General information

NPI: 1205831211
Provider Name (Legal Business Name): CHRISTOPHER M CROME MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4933 UTICA RIDGE RD STE 130
DAVENPORT IA
52807-3063
US

IV. Provider business mailing address

4933 UTICA RIDGE RD STE 130
DAVENPORT IA
52807-3063
US

V. Phone/Fax

Practice location:
  • Phone: 563-800-5238
  • Fax: 563-278-2952
Mailing address:
  • Phone: 563-676-2490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34718
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: