Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 01033450A | IN |
Y | 111NI0900X | Internist | 01033450A | IN |
NPI | 1003806829 |
---|---|
Provider Name | Dr. Steven P. Crowell |
First Address | South Bend, IN 46617-2808 |
Second Address | South Bend, IN 46617-2808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 03/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100223940 | (05) | IN |
A15659 | (02) | IN |