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NPI Code Detail

MEDICARE: ROBERT JAMES CRONK

MEDICARE: ROBERT JAMES CRONK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician66558WI
2390200000XStudent in an Organized Health Care Education/Training Program
3207RH0003XHematology & Oncology Physician66558WI

General Provider Information

NPI Number : 1013301241
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT JAMES CRONK
Provider Business Mailing Address
First Line : 9200 W WISCONSIN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-3522
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9200 W WISCONSIN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-3522
Country : US
Telephone Number : 414-805-0509
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2015
Last Update Date : 09/09/2021

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