Physician Compare National (NPI:1891976270)

HEALTHCARE PROVIDER: MICHAEL E CROUCH M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1891976270
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688716855
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101118000933
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CROUCH
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	RHEUMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	105 PINE BLUFF RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 7
	Group Practice or individual's line 2 address
City	SALISBURY
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	218017199
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	210019
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PENINSULA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	490037
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	RIVERSIDE SHORE MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	210037
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	UNIVERSITY OF MD SHORE MEDICAL CENTER AT EASTON
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y