Provider Demographics
NPI:1770724841
Name:CRANE, F. MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:F. MICHAEL
Middle Name:
Last Name:CRANE
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 1:1515 N 400 E
Mailing Address - Street 2:104
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-7561
Mailing Address - Country:US
Mailing Address - Phone:435-755-6061
Mailing Address - Fax:435-755-6091
Practice Address - Street 1:1515 N 400 E
Practice Address - Street 2:104
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-7561
Practice Address - Country:US
Practice Address - Phone:435-755-6061
Practice Address - Fax:435-755-6091
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT180115-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine