Provider Demographics
NPI:1720016330
Name:CROWE, CHRISTOPHER H (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:H
Last Name:CROWE
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:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-6001
Mailing Address - Country:US
Mailing Address - Phone:701-364-8000
Mailing Address - Fax:701-364-8078
Practice Address - Street 1:3000 32ND AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6132
Practice Address - Country:US
Practice Address - Phone:701-364-8000
Practice Address - Fax:701-364-8078
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND67862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND142006OtherUCARE #
ND9639OtherSIOUX VALLEY #
ND1600846OtherFGO MEDICA #
ND3T306CROtherMNBS #
ND010218100Medicaid
ND11984OtherNDBS #
ND900602OtherARAZ #
NDDA9011015526OtherPREF 1 #
ND1600844OtherINN MEDICA #
ND17853Medicaid
NDHP25732OtherHEALTHPARTNERS #
ND900602OtherARAZ #
ND1600846OtherFGO MEDICA #
NDHP25732OtherHEALTHPARTNERS #