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Individual

MARK J CRNKOVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3525 OLENTANGY RIVER RD, COLUMBUS, OH 43214-3937
(614) 566-5000
(614) 566-6958
Mailing address
PO BOX 182039, DEPT 086, COLUMBUS, OH 43218-2039
(614) 261-3712
(614) 447-9593

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
35052254
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000118957
ANTHEM
05
0644477
OH
Enumeration date
07/03/2006
Last updated
07/08/2007
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