Provider Demographics
NPI:1205831211
Name:CROME, CHRISTOPHER M (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:CROME
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 1:2140 53RD AVE
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-6279
Mailing Address - Country:US
Mailing Address - Phone:563-421-5700
Mailing Address - Fax:563-421-5839
Practice Address - Street 1:2140 53RD AVE
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-6279
Practice Address - Country:US
Practice Address - Phone:563-421-5700
Practice Address - Fax:563-421-5839
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA34718207Q00000X
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA01L5OtherJOHN DEERE HEALTH PLAN
207294OtherIOWA HEALTH SOLUTIONS
4796890008OtherDMERC
095541OtherHEALTH ALLIANCE
IA2242610Medicaid
IA36669OtherWELLMARK BC/BS
P00140447Medicare ID - Type UnspecifiedRAILROAD MEDICARE
4796890008OtherDMERC
IA36669OtherWELLMARK BC/BS