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NPI Code Detail

MEDICARE: MARK E CRUM M.D.

MEDICARE: MARK E CRUM M.D.
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
1207L00000XAnesthesiology PhysicianH0274TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013967959
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK E CRUM M.D.
Provider Business Mailing Address
First Line : PO BOX 34717
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78265-4717
Country : US
Telephone Number : 210-615-1187
Fax Number : 210-614-2180
Provider Business Practice Location Address
First Line : 4242 MEDICAL DR
Second Line : SUITE 3100
City : SAN ANTONIO
State : TX
Zip : 78229-5640
Country : US
Telephone Number : 210-615-1187
Fax Number : 210-614-2180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 07/16/2010

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