Provider Demographics
NPI:1033135918
Name:CRONIN, BRIAN COLUM (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:COLUM
Last Name:CRONIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 FITZWATERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1332
Mailing Address - Country:US
Mailing Address - Phone:215-657-2012
Mailing Address - Fax:215-657-2018
Practice Address - Street 1:735 FITZWATERTOWN RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1332
Practice Address - Country:US
Practice Address - Phone:215-657-2012
Practice Address - Fax:215-657-2018
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070366-L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001906590001Medicaid
PA2105104000OtherKEYSYONE
PA1418837OtherHIGHMARK BLUE SHIELD
PA3507769OtherCIGNA
PA02334MD70366LOtherHEALTH PARTNERS
PA30001543OtherKEYSTONE MERCY
PA390008468OtherRR MEDICARE
PA231952978OtherTAX ID
PA7114525OtherAETNA
PA3507769OtherCIGNA
PA390008468OtherRR MEDICARE