Provider Demographics
NPI:1497909303
Name:CROWE, MARK ELLIOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ELLIOTT
Last Name:CROWE
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 1:2006 FRANKLIN ST SE
Mailing Address - Street 2:STE 301
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4551
Mailing Address - Country:US
Mailing Address - Phone:256-539-9471
Mailing Address - Fax:256-539-9472
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:STE 301
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4551
Practice Address - Country:US
Practice Address - Phone:256-539-9471
Practice Address - Fax:256-539-9472
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL31583207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0511-26174OtherBLUE CROSS BLUE SHIELD ALABAMA
GAP01208730OtherRAILROAD MEDICARE
AL0511-26173OtherBLUE CROSS BLUE SHIELD ALABAMA
AL0511-26137OtherBLUE CROSS BLUE SHIELD ALABAMA
AL1497909303Medicaid
AL102I053486Medicare PIN