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Individual

DR. RICHARD ERIC CRUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
273 WINTON M BLOUNT LOOP, MONTGOMERY, AL 36117-3507
(334) 280-1500
(334) 280-1600
Mailing address
PO BOX 241587, MONTGOMERY, AL 36124-1587
(334) 280-1500
(334) 280-1600

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
13372
AL
207RI0011X
Interventional Cardiology Physician
Primary
13372
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051006851
BLUE SHIELD PROVIDER #
AL
01
051006982
BLUE SHIELD PROVIDER #
AL
01
051089507
BLUE SHIELD PROVIDER #
AL
01
051544338
BLUE SHIELD PROVIDER #
AL
01
13372
MEDICAL LICENSE
AL
05
89507
AL
Enumeration date
07/10/2006
Last updated
03/07/2023
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