Individual
MATTHEW EVAN KROSIN
Active
Individual
MATTHEW EVAN KROSIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01083268A
IN
2085R0204X
Vascular & Interventional Radiology Physician
01083268A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300025200
—
IN
01
—
959090106
MEDICARE PTAN
IN
01
—
Q00114643
RAILROAD PTAN
IN
Enumeration date
04/06/2014
Last updated
12/28/2023
Update your record
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