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NPI Code Detail

MEDICARE: DR. LYNN CROTEAU MD

MEDICARE: DR. LYNN CROTEAU 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
1208000000XPediatrics Physician35056989OH

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 : 1649225004
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LYNN CROTEAU MD
Provider Business Mailing Address
First Line : 4600 WESLEY AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45212-2298
Country : US
Telephone Number : 513-841-5520
Fax Number : 513-841-1580
Provider Business Practice Location Address
First Line : 7810 5 MILE RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45230-2356
Country : US
Telephone Number : 513-232-1253
Fax Number : 513-232-4290
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 01/07/2010

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Directions to “ DR. LYNN CROTEAU MD” Practice Location

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