Provider Demographics
NPI:1669519211
Name:CHRISTOPHER T CROSBY DPM
Entity type:Organization
Organization Name:CHRISTOPHER T CROSBY DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:T
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:843-237-7008
Mailing Address - Street 1:PO BOX 3231
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-3231
Mailing Address - Country:US
Mailing Address - Phone:843-237-7008
Mailing Address - Fax:843-235-9141
Practice Address - Street 1:58 ALSTON RD
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-6600
Practice Address - Country:US
Practice Address - Phone:843-237-7008
Practice Address - Fax:843-235-9141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC566213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP9924Medicaid
SCGP9924Medicaid
SCGP9924Medicaid
SC=========OtherBCBS
SCU97996Medicare UPIN
SC5088730001Medicare NSC