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General NPI Number Information
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NPI Number | 1326782228
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Entity Type | Individual
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Provider Name | ADAM CROUSE PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 205 SOUTH FRONT STREET, 4TH FLOOR BMA
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City | HARRISBURG
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State | PA
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Zip | 17104-1619
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Country | US
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Telephone | 717-761-0200
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Fax | 717-761-0641
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Provider Business Mailing Address
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Address Line | 205 SOUTH FRONT STREET 4TH FLOOR BMA
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City | HARRISBURG
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State | PA
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Zip | 17104
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Country | US
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Telephone | 717-761-0200
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Fax | 717-761-0641
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA063623
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | MA063623
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License Number State | PA
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