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NPI Code Detail

MEDICARE: DAVID R. CROTZER M.D.

MEDICARE:   DAVID R. CROTZER  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
1207VX0201XGynecologic Oncology PhysicianL6019TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00334395OTHERNERAILROAD MEDICARE

Other Identifiers

General Provider Information

NPI Number : 1578514956
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID R. CROTZER M.D.
Provider Business Mailing Address
First Line : PO BOX 10190
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23450-0190
Country : US
Telephone Number : 800-477-5240
Fax Number : 757-463-6572
Provider Business Practice Location Address
First Line : 8303 DODGE ST
Second Line : SUITE # 300
City : OMAHA
State : NE
Zip : 68114-4108
Country : US
Telephone Number : 402-354-5250
Fax Number : 402-354-3437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 12/13/2013

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Directions to “ DAVID R. CROTZER M.D.” Practice Location

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