Healthcare Provider Details

I. General information

NPI: 1689666299
Provider Name (Legal Business Name): RAY D CROUCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E NORTH AVE
PITTSBURGH PA
15212-4756
US

IV. Provider business mailing address

320 E NORTH AVE
PITTSBURGH PA
15212-4756
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-6656
  • Fax: 412-359-6653
Mailing address:
  • Phone: 412-359-6656
  • Fax: 412-359-6653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD061781L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD061781L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD061781L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: