Provider Demographics
NPI:1255656096
Name:CRUTE, MEGHAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:M
Last Name:CRUTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19637 CENTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3634
Mailing Address - Country:US
Mailing Address - Phone:440-444-4445
Mailing Address - Fax:440-742-4050
Practice Address - Street 1:19637 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3634
Practice Address - Country:US
Practice Address - Phone:440-444-4445
Practice Address - Fax:440-742-4050
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.122527207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0325559Medicaid