MEDICARE: ROBERT G CRUMMIE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	106H00000X	Marriage & Family Therapist
3	2084F0202X	Forensic Psychiatry Physician
4	2084P0802X	Addiction Psychiatry Physician
5	2084P0800X	Psychiatry Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	26275	OTHER		BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033161211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT G CRUMMIE

Provider Business Mailing Address
First Line	:	236 CHARLOTTE RD
Second Line	:
City	:	RUTHERFORDTON
State	:	NC
Zip	:	28139-2914
Country	:	US
Telephone Number	:	828-287-8861
Fax Number	:	828-287-8862

Provider Business Practice Location Address
First Line	:	236 CHARLOTTE RD
Second Line	:
City	:	RUTHERFORDTON
State	:	NC
Zip	:	28139-2914
Country	:	US
Telephone Number	:	828-287-8861
Fax Number	:	828-287-8862

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BOB G CRUMMIE
Credential	:	MD
Telephone Number	:	828-287-8861

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	06/17/2008

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