Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 25015 | IA |
NPI | 1033102686 |
---|---|
Provider Name | Dr. Michael W Crane |
First Address | Mason City, IA 50401-2926 |
Second Address | Mason City, IA 50401-2926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 01/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2229955 | (05) | IA |
A02764 | (02) | IA |