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General NPI Number Information
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NPI Number | 1356337398
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Entity Type | Individual
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Provider Name | PETER DOUGLAS ADAIR CROSBY MD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 07/20/2015
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Provider Practice Location Address
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Address Line | 44 EXECUTIVE DR
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City | NORWALK
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State | OH
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Zip | 44857-9566
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Country | US
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Telephone | 419-668-4851
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Fax | 419-663-5146
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Provider Business Mailing Address
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Address Line | PO BOX 378
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City | SANDUSKY
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State | OH
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Zip | 44871-0378
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Country | US
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Telephone | 419-609-1112
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Fax | 419-609-1123
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35069794
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License Number State | OH
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