Provider Demographics
NPI:1841916624
Name:CROUSE, DORIAN MICHEAL (PA-C)
Entity type:Individual
Prefix:MR
First Name:DORIAN
Middle Name:MICHEAL
Last Name:CROUSE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 JEWELWEED CT
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-8453
Mailing Address - Country:US
Mailing Address - Phone:937-694-6661
Mailing Address - Fax:
Practice Address - Street 1:7300 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-4119
Practice Address - Country:US
Practice Address - Phone:513-232-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty