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Individual
MR. ALLEN WAYNE CROWDER
Active
Individual
MR. ALLEN WAYNE CROWDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110004077
VA
363AS0400X
Surgical Physician Assistant
Primary
0110004077
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356685499
ANTHEM MEDIGAP
VA
01
—
371194700
BLACK LUNG
VA
01
—
P01201634
RAILROAD MEDICARE
VA
Enumeration date
11/15/2012
Last updated
07/08/2021
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