Provider Demographics
NPI:1407816077
Name:CROWDER, DAVID LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEE
Last Name:CROWDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1985 AL HIGHWAY 157
Mailing Address - Street 2:SUITE B
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-0692
Mailing Address - Country:US
Mailing Address - Phone:256-736-1405
Mailing Address - Fax:256-737-7255
Practice Address - Street 1:1985 AL HIGHWAY 157
Practice Address - Street 2:SUITE B
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0692
Practice Address - Country:US
Practice Address - Phone:256-736-1405
Practice Address - Fax:256-737-7255
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00012719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009939395Medicaid
AL051519458OtherBC
AL051519458Medicare ID - Type Unspecified
AL009939395Medicaid