Provider Demographics
NPI:1972761021
Name:CROWE, CHRISTOPHER (NAVY IDC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:CROWE
Suffix:
Gender:M
Credentials:NAVY IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BUILDING 4389 BEAUFORT ROAD
Mailing Address - Street 2:
Mailing Address - City:CHERRY POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28533
Mailing Address - Country:US
Mailing Address - Phone:252-466-0505
Mailing Address - Fax:
Practice Address - Street 1:PSC BOX 8023
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:28533-0023
Practice Address - Country:US
Practice Address - Phone:252-466-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman