MEDICARE: ROBERT F. CROWELL D.O.

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
1	207Q00000X	Family Medicine Physician	OS003092L	PA

General Provider Information

NPI Number	:	1518925684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT F. CROWELL D.O.

Provider Business Mailing Address
First Line	:	4000 EDGMONT AVE
Second Line	:
City	:	BROOKHAVEN
State	:	PA
Zip	:	19015-2211
Country	:	US
Telephone Number	:	610-876-3500
Fax Number	:	610-876-8660

Provider Business Practice Location Address
First Line	:	4000 EDGMONT AVE
Second Line	:
City	:	BROOKHAVEN
State	:	PA
Zip	:	19015-2211
Country	:	US
Telephone Number	:	610-876-3500
Fax Number	:	610-876-8660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	07/08/2007

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