MEDICARE: DR. ELIJAH TAYLOR CROM MD

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	207P00000X	Emergency Medicine Physician	2025-03050	NC

General Provider Information

NPI Number	:	1568106607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIJAH TAYLOR CROM MD

Provider Business Mailing Address
First Line	:	1638 OWEN DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-3424
Country	:	US
Telephone Number	:	910-615-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1638 OWEN DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-3424
Country	:	US
Telephone Number	:	910-615-4000
Fax Number	:

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

Provider Enumeration Date	:	04/25/2022
Last Update Date	:	06/03/2026

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