Provider Demographics
NPI:1922016930
Name:CROWLEY, KURT R (MD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:R
Last Name:CROWLEY
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 1:266 LANCASTER AVE
Mailing Address - Street 2:SUITE 301 BARR BLDG
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3256
Mailing Address - Country:US
Mailing Address - Phone:610-578-0155
Mailing Address - Fax:610-578-0156
Practice Address - Street 1:266 LANCASTER AVE
Practice Address - Street 2:SUITE 301 BARR BLDG
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3256
Practice Address - Country:US
Practice Address - Phone:610-578-0155
Practice Address - Fax:610-578-0156
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058769L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8676278OtherHIGHMARK BLUE SHIELD
110195917OtherRR MEDICARE
6124588OtherCIGNA
1553094OtherUNITED HEALTHCARE
565229OtherAETNA
85842OtherAETNA HMO
PA0989179000OtherINDEPENDENCE BLUE CROSS
PA0989179000OtherINDEPENDENCE BLUE CROSS
85842OtherAETNA HMO