Provider Demographics
NPI:1235700386
Name:CROMER, AUSTIN CHAPMAN-LOVETTE (PA-C)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:CHAPMAN-LOVETTE
Last Name:CROMER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5175 OLD CLEMMONS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-9087
Practice Address - Country:US
Practice Address - Phone:336-718-3960
Practice Address - Fax:336-766-3691
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-11390207Y00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology