Organization
MARY ELAINE KROSSE, DPM
Active
Other names
M. ELAINE KROSSE, DPM
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY ELAINE KROSSE DPM (OWNER)
(440) 322-4220
Entity
Organization
Contact information
Practice address
860 E BROAD ST, ELYRIA, OH 44035-6542
(440) 322-4220
(440) 322-4713
Mailing address
860 E BROAD ST, ELYRIA, OH 44035-6542
(440) 322-4220
(440) 322-4713
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002297
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000116728
ANTHEM BC/BS
OH
05
—
0644379
—
OH
01
—
42587891
MED. MUT. OF OHIO/SELECT
OH
01
—
480006005
RAILROAD MEDICARE
OH
01
—
8333415578
MED. MUT. OF OHIO/GMCS
OH
Enumeration date
11/30/2007
Last updated
06/08/2010
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